초록접수 현황
| 21F-255 | 구연 발표 |
Intraoperative electromagnetic navigational bronchoscopy guided transthoracic dye marking for localization of small peripheral lung nodules during minimally invasive surgical resection
Junghee Lee, Yong Soo Choi, Yeong Jeong Jeon, Sumin Shin, Jong Ho Cho, Hong Kwan Kim, Jhingook Kim, Jae Ill Zo, Young Mog Shim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Purpose : Localization of small peripheral lung nodule is occasionally challenging during video-assisted thoracoscopic surgery. We aimed to investigate the feasibility of intraoperative transthoracic nodule localization guided by an electromagnetic navigation bronchoscopy (ENB) system.
Methods : This is a retrospective observational study of 14 patients who underwent combined intraoperative ENB-guided nodule localization and resection between March 2021 and August 2018. Localization was performed through ENB-guided transthoracic injection of indigo carmine or indocyanine green with SPiNPerc system (Veran Medical Technologies) prior to surgical procedure under general anesthesia with double-lumen endobronchial intubation. When indocyanine green was used, fluorescence was detected using a near-infrared fluorescent thoracoscope.
Results : Of the 14 patients with 15 nodules, 11 (73%) were solid nodule, whereas 3 (20%) were part-solid nodule and 1 (7%) was ground-glass nodule. The median diameter of pulmonary nodules on CT was 9.27 mm (interquartile range, 7.97-14.12). The median depth from the visceral pleura to the margin of the nodule was 7.82 mm (6.77-14.42). Median procedure time was 27 min (18-30). Overall success rate was 93% (14/15). In one case, localization failed due to extravasation of dye and wide wedge resection was performed based on the location of the CT. The pathologic diagnosis included adenocarcinoma (n=7), metastatic carcinoma (n=7), and benign nodule (n=1). There were no complications associated with nodule localization and no patient was required conversion to thoracotomy.
Conclusion : The use of intraoperative electromagnetic transthoracic nodule localization before thoracoscopic resection of small lung nodules is safe and effective, potentially eliminating the need for digital nodule palpation.
Methods : This is a retrospective observational study of 14 patients who underwent combined intraoperative ENB-guided nodule localization and resection between March 2021 and August 2018. Localization was performed through ENB-guided transthoracic injection of indigo carmine or indocyanine green with SPiNPerc system (Veran Medical Technologies) prior to surgical procedure under general anesthesia with double-lumen endobronchial intubation. When indocyanine green was used, fluorescence was detected using a near-infrared fluorescent thoracoscope.
Results : Of the 14 patients with 15 nodules, 11 (73%) were solid nodule, whereas 3 (20%) were part-solid nodule and 1 (7%) was ground-glass nodule. The median diameter of pulmonary nodules on CT was 9.27 mm (interquartile range, 7.97-14.12). The median depth from the visceral pleura to the margin of the nodule was 7.82 mm (6.77-14.42). Median procedure time was 27 min (18-30). Overall success rate was 93% (14/15). In one case, localization failed due to extravasation of dye and wide wedge resection was performed based on the location of the CT. The pathologic diagnosis included adenocarcinoma (n=7), metastatic carcinoma (n=7), and benign nodule (n=1). There were no complications associated with nodule localization and no patient was required conversion to thoracotomy.
Conclusion : The use of intraoperative electromagnetic transthoracic nodule localization before thoracoscopic resection of small lung nodules is safe and effective, potentially eliminating the need for digital nodule palpation.
책임저자: Yong Soo Choi
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
발표자: Junghee Lee, E-mail : ts.junghee@gmail.com