Intraoperative Transbronchial Metallic Coil Marking for Small Peripheral Pulmonary Lesions in a Hybrid Operation Room.

IF 4.5 2区 医学 Q1 ONCOLOGY
Cancers Pub Date : 2024-12-01 DOI:10.3390/cancers16234038
Naoya Kawakita, Hiroaki Toba, Naoki Miyamoto, Shinichi Sakamoto, Hiroyuki Sumitomo, Taihei Takeuchi, Atsushi Morishita, Ayaka Baba, Emi Takehara, Keisuke Fujimoto, Masakazu Goto, Hiromitsu Takizawa
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引用次数: 0

Abstract

Background/Objectives: Computed tomography (CT)-guided transbronchial metallic coil marking is useful for identifying the locations of small peripheral pulmonary lesions. Even deeply located lesions may be accurately identified and resected with adequate margins. This method is also applicable to multiple lesions. The present study examined the efficacy of our marking method using cone-beam CT (CBCT) under general anesthesia in a hybrid operation room. Methods: In the hybrid operation room, an ultrathin bronchoscope was inserted into the objective bronchus under virtual bronchoscopic navigation, and a metallic coil was installed under CBCT guidance. The lesion was then resected with wedge resection by single- or 3-port video-assisted thoracoscopic surgery under fluorescence guidance. Eighty-seven patients with 90 lesions were treated between October 2016 and December 2022. The median lesion size was 11 mm and the median distance from the pleural surface was 8.7 mm. Lesions comprised 19 pure ground-glass nodule (GGN), 35 partly solid, and 36 solid types. Results: All lesions were visualized by CBCT, and metallic coils were installed into the objective bronchi. The median distance from lesions to coils was 3.6 mm, and the median marking time was 23.5 min. All lesions were resected with sufficient margins. In total, 57 lesions were diagnosed as primary lung cancer, 26 as metastatic lung tumors, 3 as nodular lymphoid hyperplasia, and 4 as others. There were no complications associated with the marking procedure. Conclusions: CBCT represents an alternative modality for identifying peripheral lung lesions due to its ability to visualize even small GGNs. It is a minimally invasive technique because the treatment sequence is completed under general anesthesia with the same quality as previous methods performed in a CT-equipped interventional radiology suite.

在混合手术室为肺部周围小病变进行术中经支气管金属线圈标记。
背景/目的:计算机断层扫描(CT)引导下的经支气管金属线圈标记可用于识别肺周围小病变的位置。即使是位于深部的病变,也可以准确地识别并切除足够的边缘。此法也适用于多发病变。本研究在综合手术室进行了全身麻醉下锥形束CT (CBCT)标记方法的临床应用。方法:在混合手术室,在虚拟支气管镜导航下将超薄支气管镜插入目标支气管,在CBCT引导下安装金属线圈。然后在荧光引导下通过单端口或三端口视频辅助胸腔镜手术楔形切除病变。2016年10月至2022年12月期间,87例患者治疗了90个病变。病灶中位大小为11 mm,距胸膜面中位距离为8.7 mm。其中纯磨玻璃结节19例,部分实性35例,实性36例。结果:所有病变均在CBCT上可见,目标支气管内置入金属线圈。病灶到线圈的中位距离为3.6 mm,中位标记时间为23.5 min。所有病灶均被切除,并留有足够的间隙。总共有57个病灶被诊断为原发性肺癌,26个为转移性肺肿瘤,3个为结节性淋巴样增生,4个为其他。没有与标记程序相关的并发症。结论:由于CBCT能够看到小的ggn,因此它代表了识别周围肺病变的另一种方式。这是一种微创技术,因为治疗过程是在全身麻醉下完成的,其质量与以前在配备ct的介入放射学套件中进行的方法相同。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cancers
Cancers Medicine-Oncology
CiteScore
8.00
自引率
9.60%
发文量
5371
审稿时长
18.07 days
期刊介绍: Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.
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