Pleural dye marking of lung nodules by electromagnetic navigation bronchoscopy

Bowling, Mark R.; Folch, Erik; Khandhar, Sandeep J.; Arenberg, Douglas A.; Awais, Omar; Minnich, Douglas J.; Pritchett, Michael; Rickman, Otis B.; Sztejman, Eric; Anciano, Carlos J.

doi:10.1111/crj.13077

Cited by 19 publications

(18 citation statements)

References 31 publications

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“…This requires the organization within multiple specialists and facilities, with potential waste of time, resources, delay in complication's management and discomfort for the patient. Some explorative studies have already evaluated the use of ENB to perform preoperative marking (16)(17)(18)(19)(20)(21)(22)(23). In the current study ENB-guided pleural dye marking as preoperative localization of small, pulmonary, highly suspected malignant lesions result feasible.…”

Section: Discussionmentioning

confidence: 81%

Electromagnetic navigation bronchoscopy localization of lung nodules for thoracoscopic resection

Mariolo¹,

Vieira²,

Stern³

et al. 2021

J Thorac Dis

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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.

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Section: Discussionmentioning

confidence: 81%

Electromagnetic navigation bronchoscopy localization of lung nodules for thoracoscopic resection

Mariolo¹,

Vieira²,

Stern³

et al. 2021

J Thorac Dis

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“…Bowling et al recently reported that ENB-guided transbronchial dye marking procedure was regarded as sufficient for surgical resection in 91.3% cases in a large scale prospective cohort study. 15 Cho et al also used ENB-guided dye markings for 32 lesions in 25 patients to localize pulmonary nodules and achieved an 87.5% success rate. 24 Meanwhile, ENB-guided transbronchial approach has a relatively low incidence rate of procedure-related complications.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, most previous studies have reported results for patients with only a single lung nodule, and data on the simultaneous resection of multiple lung nodules using ENB-guided localization are scarce. 13,15 In this study, we aimed to validate the accuracy and safety of preoperative ENB-guided transbronchial dye localization for VATS resection of multiple subsolid pulmonary nodules suspected of lung cancer. Furthermore, we also investigated follow-up results regarding changes in lung function after resections of multiple lung nodules.…”

Section: Introductionmentioning

confidence: 99%

Preoperative electromagnetic navigation bronchoscopy‐guided one‐stage multiple‐dye localization for resection of subsolid nodules: A single‐center pilot study

et al. 2021

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Background: Electromagnetic navigation bronchoscopy (ENB)-guided transbronchial dye marking and video-assisted thoracoscopic surgery (VATS) is an emerging technique that enables successful resection of multiple small subsolid pulmonary nodules. The aim of this study was to evaluate the accuracy and safety of preoperative ENB-guided transbronchial multiple dye localization for VATS resection of subsolid pulmonary nodules. Methods: As a single-center pilot study, we recruited patients with at least two small or subsolid pulmonary nodules. Multiple-dye localization was performed by intraoperative ENB-guided transbronchial injection of an indigo carmine dye. The patients underwent VATS for sublobar resection immediately after localization. The accuracy of ENB-guided dye marking was checked. Results: ENB-guided one-stage multiple dye localization was conducted for 18 pulmonary nodules in seven patients between September 2018 and December 2019. The mean diameter of the pulmonary nodules was 9.3 mm (range, 4-18) and the mean distance from the pleura to pulmonary nodule was 6 mm (range, 1-17 mm). ENBguided transbronchial multiple dye localization was successfully performed in 94.4% (17/18), and the accuracy of ENB-guided dye marking was 88.2% (15/17). When two nodules were not seen in intraoperative fields, anatomical sublobar resection was performed. There was no conversion to thoracotomy and operative mortalities. Among the seven patients, only one patient showed mild intrabronchial bleeding but stopped spontaneously. The changes in lung function after multiple wedge resections (À1.6% to 24.8%) were tolerable level. Conclusions: ENB-guided one-stage transbronchial dye localization showed accurate and safe intraoperative identification of multiple subsolid pulmonary nodules. A large scale prospective clinical study is warranted.

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“…Bowling et al performed a sub-group analysis of the dye-marking group in the USA cohort of the NAVIGATE study [ 31 ]. Among the patients, 23 subjects (24 lesions) underwent dye marking as a preparation for surgical resection.…”

Section: Electromagnetic Navigation Bronchoscopymentioning

confidence: 99%

How Bronchoscopic Dye Marking Can Help Minimally Invasive Lung Surgery

Sarsam

Baste

Thiberville

et al. 2022

JCM

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In the era of increasing availability of high-resolution chest computed tomography, the diagnosis and management of solitary pulmonary nodules (SPNs) has become a common challenging clinical problem. Meanwhile, surgical techniques have improved, and minimally invasive approaches such as robot- and video-assisted surgery are becoming standard, rendering the palpation of such lesions more difficult, not to mention pure ground-glass opacities, which cannot be felt even in open surgery. In this article, we explore the role of bronchoscopy in helping surgeons achieve successful minimally invasive resections in such cases.

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Pleural dye marking of lung nodules by electromagnetic navigation bronchoscopy

Cited by 19 publications

References 31 publications

Electromagnetic navigation bronchoscopy localization of lung nodules for thoracoscopic resection

Electromagnetic navigation bronchoscopy localization of lung nodules for thoracoscopic resection

Preoperative electromagnetic navigation bronchoscopy‐guided one‐stage multiple‐dye localization for resection of subsolid nodules: A single‐center pilot study

How Bronchoscopic Dye Marking Can Help Minimally Invasive Lung Surgery

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