Electromagnetic navigation bronchoscopy localization of lung nodules for thoracoscopic resection

Journal of Thoracic Disease

article

Agathe Seguin-Givelet¹  Alessio Vincenzo Mariolo¹  Thibault Vieira³  Jean-Baptiste Stern³  Loïc Perrot³  Raffaele Caliandro³  Remi Escande¹  Emmanuel Brian¹  Madalina Grigoroiu¹  Guillaume Boddaert¹  Dominique Gossot¹ 

[1] Thoracic Surgery Department, Institut du Thorax Curie-Montsouris-Institut Mutualiste Montsouris;Paris 13 University, Sorbonne Paris Cité, Faculty of Medicine SMBH;Pulmonology Department, Institut du Thorax Curie-Montsouris-Institut Mutualiste Montsouris

关键词: Electromagnetic navigation bronchoscopy (ENB);    dye marking;    peripheral lung nodule;    thoracoscopy;    early-stage lung cancer;    video-assisted thoracoscopic surgery (VATS);   

DOI  :  10.21037/jtd-21-223

学科分类：呼吸医学

来源: Pioneer Bioscience Publishing Company

【 摘 要 】

Background: Thoracoscopic localization of small peripheral pulmonary nodules is a concern. Failure can lead to larger parenchymal resection or conversion to thoracotomy. This study evaluates our experience in preoperative electromagnetic navigation bronchoscopy-guided localization of small peripheral lung lesions.Methods: From January 2017 to March 2020 clinical, radiographic, surgical, and pathological data of patients who underwent electromagnetic navigation bronchoscopy (ENB)-guided methylene blue pleural marking of highly suspected pulmonary lesions before a full thoracoscopic resection were evaluated. Localization was performed for solid or mixed subpleural nodules measuring <10 mm, solid nodules measuring <20 mm located at more than 1 cm from the pleura and any pure ground glass opacity. Successful localization was defined as successful identification and thoracoscopic resection of target lesions.Results: Forty-eight patients were included: 30 solid nodules (63%), 12 pure GGO (25%) and 6 mixed (13%). The median largest diameter at CT-scan was 11 mm (IQR, 9–14 mm) while the median distance from the pleural surface was 12 mm (IQR, 6–16 mm). The median ENB length was 25 min (19–33 min). Localization procedure was successful in 45 cases (94%). No procedural-related complications were reported.Conclusions: ENB is a safe and accurate preoperative procedure to localize small lung peripheral lesions. The high successful rate, the absence of related complications, the possibility of performing the procedure in the same operating room with a single general anesthesia, make ENB-guided dye marking an advantageous tool for thoracoscopic pulmonary resection.

【 授权许可】

Unknown