Robot-Assisted Bronchoscopy for Identification of Lung Nodules During Minimally Invasive Pulmonary Resection.

IF 1.6 Q2 SURGERY
James Shahoud, Benny Weksler, Sohini Ghosh, Aarthi Ganesh, Hiran Fernando
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引用次数: 0

Abstract

Objective: Small pulmonary nodules can be difficult to identify during minimally invasive surgical (MIS) resection. Previous investigators have reported using standard bronchoscopy with electromagnetic navigation to identify small pulmonary nodules. Robot-assisted bronchoscopy has been introduced into clinical practice and has shown utility for the biopsy of small lesions. We report our experience using robot-assisted bronchoscopy with dye marking to aid in minimally invasive pulmonary resection.

Methods: Patients with peripheral pulmonary nodules underwent robot-assisted bronchoscopy before a planned minimally invasive resection. Indocyanine green or methylene blue was injected directly into the targeted lesion. Surgical resection was then immediately performed. Success was defined as dye visualization leading to sublobar resection of the target nodule without the need for lobectomy or thoracotomy.

Results: Thirty patients with a single targeted nodule underwent robot-assisted bronchoscopy followed by MIS resection. The median lesion size was 9 mm (4 to 25 mm), and the median distance from the pleura was 5 mm (1 to 32 mm). The success rate was 83.3% (25 of 30). There were 3 cases in which the dye was not visualized, and in 2 cases there was free extravasation of dye. The targeted nodule was identified in these 5 patients without the need for thoracotomy or lobectomy. Pathology revealed non-small cell lung cancer (n = 13, 43.3%), metastatic disease (n = 11, 36.7%), and benign disease (n = 6, 20%). There were no complications related to the use of robot-assisted bronchoscopy.

Conclusions: Robot-assisted bronchoscopy with dye marking is safe and effective for guiding minimally invasive resection of small peripheral pulmonary nodules.

机器人辅助支气管镜在微创肺切除术中识别肺结节
目的:微创手术(MIS)切除时很难识别肺部小结节。以前的研究者曾报告过使用标准支气管镜和电磁导航来识别肺部小结节。机器人辅助支气管镜已被引入临床实践,并显示出其在小病灶活检方面的实用性。我们报告了使用带有染料标记的机器人辅助支气管镜辅助微创肺切除术的经验:方法:外周肺结节患者在计划的微创切除术前接受机器人辅助支气管镜检查。将吲哚菁绿或亚甲蓝直接注入目标病灶。然后立即进行手术切除。成功的定义是染料可视化导致肺叶下靶结节切除,而无需进行肺叶切除或开胸手术:30名单个目标结节患者接受了机器人辅助支气管镜检查和MIS切除术。病灶的中位尺寸为 9 毫米(4 至 25 毫米),与胸膜的中位距离为 5 毫米(1 至 32 毫米)。成功率为 83.3%(30 例中有 25 例)。有 3 例未观察到染料,2 例染料自由外渗。在这 5 例患者中,无需进行开胸手术或肺叶切除术即可确定目标结节。病理结果显示为非小细胞肺癌(13 例,占 43.3%)、转移性疾病(11 例,占 36.7%)和良性疾病(6 例,占 20%)。使用机器人辅助支气管镜检查未出现并发症:带染料标记的机器人辅助支气管镜可安全有效地引导微创切除周围肺部小结节。
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来源期刊
CiteScore
2.00
自引率
6.70%
发文量
80
期刊介绍: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery
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