A comparison of efficacy and safety of preoperative versus intraoperative computed tomography-guided thoracoscopic lung resection

Chao, Yin‐Kai; Pan, Kuang-Tse; Chen, Wen; Fang, Hsin-Yueh; Hsieh, Ming‐Ju

doi:10.1016/j.jtcvs.2018.06.088

Cited by 54 publications

(70 citation statements)

References 22 publications

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“…Such marking can be achieved not only with conventional fiducials and dyes: indocyanine green (ICG) fluorescence marking allows for very clear intra‐operative detection using infrared video systems; and even radio‐frequency identification tagging is being developed . Expensive hybrid operating room systems are also said to offer useful on‐table localization of lung lesions – though this comes at a price . Although conclusive evidence for the efficacy of these new technologies is yet to emerge, they offer promising options to tackle the problem of GGO detection.…”

Section: Making Sublobar Resection Accessiblementioning

confidence: 99%

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Surgical management of ground glass opacities of the lung

Sihoe¹

2020

Surgical Practice

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Emerging evidence for the efficacy of low‐dose CT thorax screening for lung cancer is undoubtedly good news for patients. However, the by‐product is increasing incidental detection of lung lesions know as ground‐glass opacities (GGOs). Because these may or may not develop into lung cancer, a number of guidelines currently exist to help clinicians decide how to manage them. These guidelines are characterized by a reliance on CT imaging alone, an inherent aversion to surgery, and a failure to recognize the possibility of variance in GGO pathology between populations in different parts of the world. As a result, surgeons in particular are inadequately served by these guidelines. This article explores how recent advanced in thoracic surgery may play important roles in shaping GGO management, and how surgery may need to feature more prominently in future guidelines.

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Section: Making Sublobar Resection Accessiblementioning

confidence: 99%

“…58 Expensive hybrid operating room systems are also said to offer useful on-table localization of lung lesionsthough this comes at a price. 59 Although conclusive evidence for the efficacy of these new technologies is yet to emerge, they offer promising options to tackle the problem of GGO detection.…”

Section: Making Sublobar Resection Accessiblementioning

confidence: 99%

Surgical management of ground glass opacities of the lung

Sihoe¹

2020

Surgical Practice

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“…The sample size was established according to a retrospective study previously designed by our group [19]. The original assumption was that the time required for tumor localization would be similar in the IOCT and POCT groups.…”

Section: Sample Size Calculationmentioning

confidence: 99%

Preoperative CT versus Intraoperative Hybrid DynaCT Imaging for Localization of Small Pulmonary Nodules: A Randomized Controlled Trial

Chao

Pan

Chen

et al. 2018

Preprint

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KEYWORDShybrid operating room, solitary pulmonary nodules, localization, ARTIS zeego 2 Abstract Background Small and/or deep pulmonary nodules have been traditionally localized using preoperative CT (POCT)imaging. However, the advent of hybrid operating rooms (ORs) has allowed intraoperative computed tomography (IOCT)-guided lesion localization. This single center, open-label, randomized, controlled clinical trial aims to compare the efficacy and safety of IOCT versus POCT. Methods/designThe study sample will consist of patients presenting with small and/or deep pulmonary nodules who will be randomly allocated to either POCT or IOCT. The time required for identifying the lesion will be the primary efficacy outcome. The following parameters will serve as secondary endpoints: rate of successful targeting in the operating field, time at risk, complication (pneumothorax and hemorrhage) rates, and radiation exposure. DiscussionOwing to the increased availability of HORs, our data will be crucial to clarify the feasibility and safety of IOCT versus the traditional POCT approach.

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“…There is an emerging body of research into developing and evaluating localization techniques that can help targeted resection of small lung nodules 9‐12 . These techniques are combined with surgery and include intraoperative adjuncts (ultrasound, fluoroscopy); markers placed preoperatively or intraoperatively, such as hookwires, fiducials, microcoils, or radioactive seeds; dyes (methylene blue and indocyanine green [ICG]); and molecular targets (flourophores) 13‐24 .…”

Section: Introductionmentioning

confidence: 99%

Image‐guided video‐assisted thoracoscopic resection (iVATS): Translation to clinical practice—real‐world experience

Gill

Barlow

Jaklitsch

et al. 2020

Journal of Surgical Oncology

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Objective: We developed a novel approach for localization and resection of lung nodules, using image-guided video-assisted thoracoscopic surgery (iVATS). We report our experience of translating iVATS into clinical care.Methods: Methodology and workflow for iVATS developed as part of the Phase I/II trial were used to train surgeons, radiologists, anesthesiologists, and radiology technologists. Radiation dose, time from induction to incision, placement of T-bar to incision and incision to closure, hospital stay, and complication rates were recorded.Results: Fifty patients underwent iVATS for resection of 54 nodules in a clinical hybrid operating room (OR) by six surgeons. Fifty-two (97%) nodules were successfully resected.Forty-two (84%) patients underwent wedge resection, four (7%) lobectomies, and two (4%) segmentectomy all with lymph node dissection. Median time from induction to incision was 89 minutes (range: 13-256 minutes); T-bar placement was 14 minutes (10-29 minutes); and incision to closure, 107 minutes (41-302 minutes). Average and total procedure radiation dose were: median = 6 mSieverts (range: 2.9-35 mSieverts). No deaths were reported and median length of stay was 3 days (range: 1-12 days).Conclusions: Translation of iVATS into clinical practice has been initiated using a safe step-wise process, combining intraoperative C-arm computed tomography scanning and thoracoscopic surgery in a hybrid OR. K E Y W O R D Sadvanced image-guided operating room, C-arm CT, fiducials, hybrid operating room, lung cancer, VATS

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A comparison of efficacy and safety of preoperative versus intraoperative computed tomography-guided thoracoscopic lung resection

Cited by 54 publications

References 22 publications

Surgical management of ground glass opacities of the lung

Surgical management of ground glass opacities of the lung

Preoperative CT versus Intraoperative Hybrid DynaCT Imaging for Localization of Small Pulmonary Nodules: A Randomized Controlled Trial

Image‐guided video‐assisted thoracoscopic resection (iVATS): Translation to clinical practice—real‐world experience

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