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Efficacy and safety of intraoperative cone-beam CT-guided localization of small pulmonary nodules

OBJECTIVES: This study aimed to evaluate the efficacy and safety of intraoperative cone-beam computed tomography-guided video-assisted thoracoscopic surgery wedge resection of impalpable small pulmonary nodules. METHODS: This was a single-centre phase 2 trial conducted between April 2018 and March 2...

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Autores principales: Kaiho, Taisuke, Suzuki, Hidemi, Hata, Atsushi, Ito, Takamasa, Tanaka, Kazuhisa, Sakairi, Yuichi, Kato, Hideyuki, Shiko, Yuki, Kawasaki, Yohei, Yoshino, Ichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9492248/
https://www.ncbi.nlm.nih.gov/pubmed/36102798
http://dx.doi.org/10.1093/icvts/ivac236
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author Kaiho, Taisuke
Suzuki, Hidemi
Hata, Atsushi
Ito, Takamasa
Tanaka, Kazuhisa
Sakairi, Yuichi
Kato, Hideyuki
Shiko, Yuki
Kawasaki, Yohei
Yoshino, Ichiro
author_facet Kaiho, Taisuke
Suzuki, Hidemi
Hata, Atsushi
Ito, Takamasa
Tanaka, Kazuhisa
Sakairi, Yuichi
Kato, Hideyuki
Shiko, Yuki
Kawasaki, Yohei
Yoshino, Ichiro
author_sort Kaiho, Taisuke
collection PubMed
description OBJECTIVES: This study aimed to evaluate the efficacy and safety of intraoperative cone-beam computed tomography-guided video-assisted thoracoscopic surgery wedge resection of impalpable small pulmonary nodules. METHODS: This was a single-centre phase 2 trial conducted between April 2018 and March 2019. Peripheral small pulmonary nodules, defined as either ground-glass opacity-dominant (>50%) nodules measuring ≤3 cm in diameter (ground-glass opacity-dominant type) or nodules measuring ≤2 cm in diameter located deeper than the nodule diameter from the visceral pleura (deep solid type), were eligible for resection using a cone-beam computed tomography-guided thoracoscopic manner. The primary end-point was macroscopic complete resection, and secondary end-points were: nodule extraction rate, operation time, localization time, marking accuracy, microscopic complete resection and safety. RESULTS: Twenty-two nodules, in 9 men and 11 women with a mean age of 64.3 years, were visualized and resected. The nodules were located in the right upper, middle and lower lobes in 3, 1 and 5 patients, respectively, and in the left upper and lower lobes in 5 and 8 patients, respectively. Seven nodules were ground-glass opacity-dominant types, and 15 were deep solid types. Cone-beam computed tomography could clearly image all nodules. The mean time for localization was 17.4 min. The mean operation time was 110.7 min. Macroscopic complete resection was accomplished in 21 nodules (95.5%). Microscopic complete resection was achieved in all nodules (100%). Postoperative air leakage and bleeding were observed in 1 patient (5%). CONCLUSIONS: Cone-beam computed tomography might be a safe and useful guide for video-assisted thoracoscopic surgery wedge resection of impalpable peripheral pulmonary nodules. DATE AND NUMBER OF IRB APPROVAL: 15 November 2017, 381. CLINICAL TRIAL REGISTRATION NUMBER: UMIN 000030388.
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spelling pubmed-94922482022-09-22 Efficacy and safety of intraoperative cone-beam CT-guided localization of small pulmonary nodules Kaiho, Taisuke Suzuki, Hidemi Hata, Atsushi Ito, Takamasa Tanaka, Kazuhisa Sakairi, Yuichi Kato, Hideyuki Shiko, Yuki Kawasaki, Yohei Yoshino, Ichiro Interact Cardiovasc Thorac Surg Thoracic OBJECTIVES: This study aimed to evaluate the efficacy and safety of intraoperative cone-beam computed tomography-guided video-assisted thoracoscopic surgery wedge resection of impalpable small pulmonary nodules. METHODS: This was a single-centre phase 2 trial conducted between April 2018 and March 2019. Peripheral small pulmonary nodules, defined as either ground-glass opacity-dominant (>50%) nodules measuring ≤3 cm in diameter (ground-glass opacity-dominant type) or nodules measuring ≤2 cm in diameter located deeper than the nodule diameter from the visceral pleura (deep solid type), were eligible for resection using a cone-beam computed tomography-guided thoracoscopic manner. The primary end-point was macroscopic complete resection, and secondary end-points were: nodule extraction rate, operation time, localization time, marking accuracy, microscopic complete resection and safety. RESULTS: Twenty-two nodules, in 9 men and 11 women with a mean age of 64.3 years, were visualized and resected. The nodules were located in the right upper, middle and lower lobes in 3, 1 and 5 patients, respectively, and in the left upper and lower lobes in 5 and 8 patients, respectively. Seven nodules were ground-glass opacity-dominant types, and 15 were deep solid types. Cone-beam computed tomography could clearly image all nodules. The mean time for localization was 17.4 min. The mean operation time was 110.7 min. Macroscopic complete resection was accomplished in 21 nodules (95.5%). Microscopic complete resection was achieved in all nodules (100%). Postoperative air leakage and bleeding were observed in 1 patient (5%). CONCLUSIONS: Cone-beam computed tomography might be a safe and useful guide for video-assisted thoracoscopic surgery wedge resection of impalpable peripheral pulmonary nodules. DATE AND NUMBER OF IRB APPROVAL: 15 November 2017, 381. CLINICAL TRIAL REGISTRATION NUMBER: UMIN 000030388. Oxford University Press 2022-09-14 /pmc/articles/PMC9492248/ /pubmed/36102798 http://dx.doi.org/10.1093/icvts/ivac236 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Thoracic
Kaiho, Taisuke
Suzuki, Hidemi
Hata, Atsushi
Ito, Takamasa
Tanaka, Kazuhisa
Sakairi, Yuichi
Kato, Hideyuki
Shiko, Yuki
Kawasaki, Yohei
Yoshino, Ichiro
Efficacy and safety of intraoperative cone-beam CT-guided localization of small pulmonary nodules
title Efficacy and safety of intraoperative cone-beam CT-guided localization of small pulmonary nodules
title_full Efficacy and safety of intraoperative cone-beam CT-guided localization of small pulmonary nodules
title_fullStr Efficacy and safety of intraoperative cone-beam CT-guided localization of small pulmonary nodules
title_full_unstemmed Efficacy and safety of intraoperative cone-beam CT-guided localization of small pulmonary nodules
title_short Efficacy and safety of intraoperative cone-beam CT-guided localization of small pulmonary nodules
title_sort efficacy and safety of intraoperative cone-beam ct-guided localization of small pulmonary nodules
topic Thoracic
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9492248/
https://www.ncbi.nlm.nih.gov/pubmed/36102798
http://dx.doi.org/10.1093/icvts/ivac236
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