Electromagnetic Navigation Bronchoscopy in Hybrid Theater

Zhao, Ze‐Rui; Lau, Rainbow W. H.; Ng, Calvin S.H.

doi:10.3389/fsurg.2019.00010

Cited by 6 publications

(4 citation statements)

References 23 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Meanwhile, microwave energy produces a larger and more predictable ablation zone, as it is minimally affected by impedance and has less heat-sink effects (11). Building upon our institute's experience in lung nodule dye-marking and biopsy via electromagnetic navigation bronchoscopy (ENB) (13,14), we identified a selected group of cases which are suitable for bronchoscopic transbronchial microwave ablation under ENB guidance. Being one of the first centres to perform ENB microwave ablation in clinical setting, we retrospectively analyze data from the first cohort of patients who had completed the procedure.…”

Section: Introductionmentioning

confidence: 99%

Transbronchial microwave ablation of lung nodules with electromagnetic navigation bronchoscopy guidance—a novel technique and initial experience with 30 cases

Chan¹,

Lau²,

Ngai³

et al. 2021

Transl Lung Cancer Res

Self Cite

View full text Add to dashboard Cite

Background: Microwave ablation of lung nodules may provide a faster, larger and more predictable ablation zone than other energy sources, while bronchoscopic transbronchial ablation has theoretical advantage of fewer pleural-based complications than percutaneous approach. Our study aims to determine whether the novel combination of bronchoscopic approach and microwave ablation in management of lung nodules is technically feasible, safe and effective.Methods: This is a retrospective analysis of a single center experience in electromagnetic navigation bronchoscopy microwave ablation in hybrid operating room. Patients had high surgical risks while lung nodules were either proven malignant or radiologically suspicious. Primary endpoints include technical feasibility and safety.Results: Total of 30 lung nodules from 25 patients were treated. Mean nodule size was 15.1 mm, and bronchus directly leads to the nodules (bronchus sign positive) in only half of them. Technical success rate was 100%, although some nodules required double ablation for adequate coverage. Mean minimal ablation margin was 5.51 mm. The mean actual ablation zone volume was −21.4% compared to predicted, likely due to significant tissue contraction ranging from 0-43%. There was no significant heat sink effect.Mean hospital stay was 1.73 days, and only 1 patient stayed for more than 3 days. Complications included pain (13.3%), pneumothorax requiring drainage (6.67%), post-ablation reaction (6.67%), pleural effusion (3.33%) and hemoptysis (3.33%). After median follow up of 12 months, none of the nodules had evidence of progression.Conclusions: Bronchoscopic transbronchial microwave ablation is safe and feasible for treatment of malignant lung nodules. Prospective study on clinical application of this novel technique is warranted.

show abstract

Section: Introductionmentioning

confidence: 99%

Transbronchial microwave ablation of lung nodules with electromagnetic navigation bronchoscopy guidance—a novel technique and initial experience with 30 cases

Chan¹,

Lau²,

Ngai³

et al. 2021

Transl Lung Cancer Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…Several methods have been developed to support the intraoperative localization of small lesions prior to thoracoscopic resection [ 12 – 14 ]. The most profound approaches are preoperative guide wire placement by the interventional radiologists and electromagnetically guided bronchoscopy [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Computer tomography guided thoracoscopic resection of small pulmonary nodules in the hybrid theatre

et al. 2021

View full text Add to dashboard Cite

Purpose Thoracic surgeons are currently asked to resect smaller and deeper lesions which are difficult to detect thoracoscopically. The growing number of those lesions arises both from lung cancer screening programs and from follow-up of extrathoracic malignancies. This study analyzed the routine use of a CT-aided thoracoscopic approach to small pulmonary nodules in the hybrid theatre and the resulting changes in the treatment pathway. Methods 50 patients were retrospectively included. The clinical indication for histological diagnosis was suspected metastasis in 46 patients. Technically, the radiological distance between the periphery of the lesion and the visceral pleura had to exceed the maximum diameter of the lesion for the patient to be included. A spiral wire was placed using intraoperative CT-based laser navigation to guide the thoracoscopic resection. Results The mean diameter of the lesions was 8.4 mm (SD 4.27 mm). 29.4 minutes (SD 28.5) were required on average for the wire placement and 42.3 minutes (SD 20.1) for the resection of the lesion. Histopathology confirmed the expected diagnosis in 30 of 52 lesions. In the remaining 22 lesions, 9 cases of primary lung cancer were detected while 12 patients showed a benign disease. Conclusion Computer tomography assisted thoracoscopic surgery (CATS) enabled successful resection in all cases with minimal morbidity. The histological diagnosis led to a treatment change in 42% of the patients. The hybrid-CATS technique provides good access to deeply located small pulmonary nodules and could be particularly valuable in the emerging setting of lung cancer screening.

show abstract

“…This will lead to the following issues: (I) While the findings of the two large multicenter RCTS that address the issue of sublobar resection versus lobectomy-the Japanese RCT: JCOG0802/ WJOG4607L, and the North American RCT CALGB 140503-are eagerly anticipated, we are already witnessing an increasingly common use of sublobar resection in the thoracic surgical community for the treatment of small lesions, including GGOs. (II) Following on the previous point, there will be increasing effort to develop sophisticated and reliable means for the accurate localization of these small lung lesions, such as the routine use of 3 D CT reconstruction in the preoperative planning, electromagnetic navigational bronchoscopy with or without intraoperative real time CT imaging (19). (III) The incorporation of ablative therapy into the armamentarium of treatment for small lung cancers in appropriately selected patients.…”

Section: Expert Opinion 1: Dr Michael K Hsinmentioning

confidence: 99%

The 100 most cited articles on thoracic surgery management of lung cancer

Jin

et al. 2019

J. Thorac. Dis.

View full text Add to dashboard Cite

Identification of the top 100 cited articlesBetween July and August 2018 , we performed a retrospective bibliometric analysis, identifying articles through the Web of Science (Thomson Reuters, New York, USA) which searches the Science Citation Index Expanded database, allowing access to over 12,000 peer reviewed journals and collected citation data published since 1945.Using selected key terms ("lung cancer", "surgery'", "lobectomy", "segmentectomy", "pneumonectomy", "wedge resection", "video-assisted thoracic surgery", "thoracotomy"), our search performed between July and August 2018 yielded a total of 18,268 articles. The top 100 articles were identified subsequently which were ranked by the number of citations. Analysis of the top 100 cited articlesA further analysis of individual articles was carried out by three reviewers (J Shen, K Jin, and Q Hu) to extract relevant information for the analysis. Individual articles were reviewed to identify the authorship, journal title, journal IF, subject matter, article type (e.g., prospective analysis, retrospective analysis, meta-analysis or systematic review, randomized controlled trial, review article, guideline, technical note, or case report), institution and country of origin, level of evidence, and year of publication. The analysis method used the Australian National Health and Medical Research Council evidence hierarchy (11). Of note, this classification defines clinical guidelines as level I evidence and randomized control trials as level II evidence.Furthermore, the citation count and citations per year were extracted using the Web of Science. When there was disagreement or discordance between reviewers, the senior author (D Ma) was included to achieve consensus. ResultsThe top 100 articles regarding the thoracic surgery management of lung cancer according to the most citations received are listed in Table 1."Cisplatin-based adjuvant chemotherapy in patients with completely resected non-small-cell lung cancer", published in The New England Journal of Medicine in 2004, has received totally 1,720 citations, the most citations in the past 14 years. Of note, it also remains the most cited article per year, being cited 122.86 times on average, per year. The article with the lowest number of citations in the top 100 list, "A practical molecular assay to predict survival in resected non-squamous, non-small-cell lung cancer: Development and international validation studies", received 177 citations. Overall, the mean number of citations was 356, with the top 100 articles cited an average of 26 times per year.Only one of the top 100 articles was published prior to 1980 (Table 2), with 63% (n=63) published since the year 2000 and 13% published within the past decade. Eighteen authors contributed four or more articles (Table 3). Rusch, Ginsberg, Johnson, and Livingston have contributed the most articles. Rusch and Ginsberg were the first named authors on four articles each. Rusch is the most published author, appearing on a total of ten articles.A total of 31 journals mad...

show abstract

Electromagnetic Navigation Bronchoscopy in Hybrid Theater

Cited by 6 publications

References 23 publications

Transbronchial microwave ablation of lung nodules with electromagnetic navigation bronchoscopy guidance—a novel technique and initial experience with 30 cases

Transbronchial microwave ablation of lung nodules with electromagnetic navigation bronchoscopy guidance—a novel technique and initial experience with 30 cases

Computer tomography guided thoracoscopic resection of small pulmonary nodules in the hybrid theatre

The 100 most cited articles on thoracic surgery management of lung cancer

Contact Info

Product

Resources

About