Cargando…
Electromagnetic navigation bronchoscopic localization versus percutaneous CT‐guided localization for thoracoscopic resection of small pulmonary nodules
BACKGROUND: Identification of small pulmonary nodules is challenging in a limited intrathoracic field during minimally invasive video‐assisted thoracoscopic surgery (VATS), and preoperative localization is required. Various techniques have been reported with some failure and complications. Here, we...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons Australia, Ltd
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882377/ https://www.ncbi.nlm.nih.gov/pubmed/33398925 http://dx.doi.org/10.1111/1759-7714.13775 |
_version_ | 1783651033798410240 |
---|---|
author | Yang, Yan‐Long Li, Zi‐Zhe Huang, Wei‐Chao Zhuang, Jia Lin, Dai‐Ying Zhong, Wen‐Zhao Lan, Bin |
author_facet | Yang, Yan‐Long Li, Zi‐Zhe Huang, Wei‐Chao Zhuang, Jia Lin, Dai‐Ying Zhong, Wen‐Zhao Lan, Bin |
author_sort | Yang, Yan‐Long |
collection | PubMed |
description | BACKGROUND: Identification of small pulmonary nodules is challenging in a limited intrathoracic field during minimally invasive video‐assisted thoracoscopic surgery (VATS), and preoperative localization is required. Various techniques have been reported with some failure and complications. Here, we compare the feasibility and safety between electromagnetic navigation bronchoscopic marking and computed tomography (CT)‐guided percutaneous marking using indocyanine green (ICG) and iopamidol. METHODS: A total of 47 patients with small‐sized pulmonary nodules, scheduled to undergo video‐assisted thoracoscopic limited resection, were enrolled in this study. A mixture of diluted ICG and iopamidol was injected into the lung parenchyma as a marker, using CT‐guided percutaneous or electromagnetic navigation bronchoscopic injection techniques and the results were examined and compared. RESULTS: A total of 35 and 12 patients underwent preoperative marking by percutaneous injection and electromagnetic navigation bronchoscopic injection, respectively, in which a marker was detected in 33/35 (94.3%) and 12/12 (100%) patients. No combination of these procedures was performed in any patient. All markers were successfully detected in three patients who underwent injection marking at two different lesion sites. Pneumothorax occurred in five patients (14%) in the percutaneous marking group, which was relieved in all patients without the necessity for chest tube drainage. No other complication was observed in this study. CONCLUSIONS: Electromagnetic navigation bronchoscopic injection techniques using indocyanine green fluorescence plus iopamidol are safe and effective, and comparable with CT‐guided localization. Furthermore, a bronchoscopic approach enables marking of multiple lesion areas without increasing patient risk, especially for puncture‐related pneumothorax. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: Either computed tomography (CT)‐guided percutaneous or electromagnetic navigation bronchoscopic injection techniques can be used for preoperative marking of pulmonary nodules with indocyanine green (ICG) fluorescence. WHAT THIS STUDY ADDS: Indocyanine green (ICG) is a safe and easily detectable fluorescent marker for video‐assisted thoracoscopic surgery (VATS). A bronchoscopic injection approach enables marking of multiple lesion areas without increasing the risk of pneumothorax. |
format | Online Article Text |
id | pubmed-7882377 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley & Sons Australia, Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-78823772021-02-19 Electromagnetic navigation bronchoscopic localization versus percutaneous CT‐guided localization for thoracoscopic resection of small pulmonary nodules Yang, Yan‐Long Li, Zi‐Zhe Huang, Wei‐Chao Zhuang, Jia Lin, Dai‐Ying Zhong, Wen‐Zhao Lan, Bin Thorac Cancer Original Articles BACKGROUND: Identification of small pulmonary nodules is challenging in a limited intrathoracic field during minimally invasive video‐assisted thoracoscopic surgery (VATS), and preoperative localization is required. Various techniques have been reported with some failure and complications. Here, we compare the feasibility and safety between electromagnetic navigation bronchoscopic marking and computed tomography (CT)‐guided percutaneous marking using indocyanine green (ICG) and iopamidol. METHODS: A total of 47 patients with small‐sized pulmonary nodules, scheduled to undergo video‐assisted thoracoscopic limited resection, were enrolled in this study. A mixture of diluted ICG and iopamidol was injected into the lung parenchyma as a marker, using CT‐guided percutaneous or electromagnetic navigation bronchoscopic injection techniques and the results were examined and compared. RESULTS: A total of 35 and 12 patients underwent preoperative marking by percutaneous injection and electromagnetic navigation bronchoscopic injection, respectively, in which a marker was detected in 33/35 (94.3%) and 12/12 (100%) patients. No combination of these procedures was performed in any patient. All markers were successfully detected in three patients who underwent injection marking at two different lesion sites. Pneumothorax occurred in five patients (14%) in the percutaneous marking group, which was relieved in all patients without the necessity for chest tube drainage. No other complication was observed in this study. CONCLUSIONS: Electromagnetic navigation bronchoscopic injection techniques using indocyanine green fluorescence plus iopamidol are safe and effective, and comparable with CT‐guided localization. Furthermore, a bronchoscopic approach enables marking of multiple lesion areas without increasing patient risk, especially for puncture‐related pneumothorax. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: Either computed tomography (CT)‐guided percutaneous or electromagnetic navigation bronchoscopic injection techniques can be used for preoperative marking of pulmonary nodules with indocyanine green (ICG) fluorescence. WHAT THIS STUDY ADDS: Indocyanine green (ICG) is a safe and easily detectable fluorescent marker for video‐assisted thoracoscopic surgery (VATS). A bronchoscopic injection approach enables marking of multiple lesion areas without increasing the risk of pneumothorax. John Wiley & Sons Australia, Ltd 2021-01-04 2021-02 /pmc/articles/PMC7882377/ /pubmed/33398925 http://dx.doi.org/10.1111/1759-7714.13775 Text en © 2021 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Yang, Yan‐Long Li, Zi‐Zhe Huang, Wei‐Chao Zhuang, Jia Lin, Dai‐Ying Zhong, Wen‐Zhao Lan, Bin Electromagnetic navigation bronchoscopic localization versus percutaneous CT‐guided localization for thoracoscopic resection of small pulmonary nodules |
title | Electromagnetic navigation bronchoscopic localization versus percutaneous CT‐guided localization for thoracoscopic resection of small pulmonary nodules |
title_full | Electromagnetic navigation bronchoscopic localization versus percutaneous CT‐guided localization for thoracoscopic resection of small pulmonary nodules |
title_fullStr | Electromagnetic navigation bronchoscopic localization versus percutaneous CT‐guided localization for thoracoscopic resection of small pulmonary nodules |
title_full_unstemmed | Electromagnetic navigation bronchoscopic localization versus percutaneous CT‐guided localization for thoracoscopic resection of small pulmonary nodules |
title_short | Electromagnetic navigation bronchoscopic localization versus percutaneous CT‐guided localization for thoracoscopic resection of small pulmonary nodules |
title_sort | electromagnetic navigation bronchoscopic localization versus percutaneous ct‐guided localization for thoracoscopic resection of small pulmonary nodules |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882377/ https://www.ncbi.nlm.nih.gov/pubmed/33398925 http://dx.doi.org/10.1111/1759-7714.13775 |
work_keys_str_mv | AT yangyanlong electromagneticnavigationbronchoscopiclocalizationversuspercutaneousctguidedlocalizationforthoracoscopicresectionofsmallpulmonarynodules AT lizizhe electromagneticnavigationbronchoscopiclocalizationversuspercutaneousctguidedlocalizationforthoracoscopicresectionofsmallpulmonarynodules AT huangweichao electromagneticnavigationbronchoscopiclocalizationversuspercutaneousctguidedlocalizationforthoracoscopicresectionofsmallpulmonarynodules AT zhuangjia electromagneticnavigationbronchoscopiclocalizationversuspercutaneousctguidedlocalizationforthoracoscopicresectionofsmallpulmonarynodules AT lindaiying electromagneticnavigationbronchoscopiclocalizationversuspercutaneousctguidedlocalizationforthoracoscopicresectionofsmallpulmonarynodules AT zhongwenzhao electromagneticnavigationbronchoscopiclocalizationversuspercutaneousctguidedlocalizationforthoracoscopicresectionofsmallpulmonarynodules AT lanbin electromagneticnavigationbronchoscopiclocalizationversuspercutaneousctguidedlocalizationforthoracoscopicresectionofsmallpulmonarynodules |