Simultaneous cone beam computed tomography‐guided bronchoscopic marking and video‐assisted thoracoscopic wedge resection in a hybrid operating room

Hirohashi, Kentaro; Okada, Hironari; Miyazaki, Ryohei; Kawamoto, Nobutaka; Yamamoto, Marino; Orihashi, Kazumasa

doi:10.1111/1759-7714.12983

Cited by 11 publications

(8 citation statements)

References 13 publications

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“…We performed wedge resection for benign SPN and lobectomy or segmental lung resection and lymph node dissection for malignant SPN, except for three patients who were converted to open surgery intraoperatively due to pleural atresia. This shows that both benign and malignant SPN can be diagnosed and effectively treated with VATS [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Analysis of Video-Assisted Thoracoscopic Surgery for Resection of Solitary Pulmonary Nodules and Influencing Factors in the Diagnosis of Benign and Malignant Nodules

Yue¹,

Fan

Zhang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Purpose. This is a retrospective research comparing the clinical outcomes of single-hole versus multi-hole video-assisted thoracoscopic surgical (VATS) resection for solitary pulmonary nodules (SPN) and examining the factors influencing the diagnosis of benign and malignant pulmonary nodules. Method. We collected the clinical data, surgical status, outcomes, and corresponding imaging features of 317 patients with SPN who were surgically resected by VATS and diagnosed as benign or malignant by pathology in our hospital from January 2019 to December 2021. Result. Among the 317 patients, 124 (39.12%) underwent single-port VATS and 193 (60.88%) underwent multiple-hole VATS. All patients were grouped according to the different surgical methods, and their postoperative indicators were statistically analyzed. The results showed that neither the single-port VATS group nor the multi-port VATS group had any serious adverse events such as death during the perioperative period. The average operation time, intraoperative blood loss, drainage tube indwelling time, and postoperative hospital stay were significantly lower in the two groups. Statistics of postoperative pathological diagnosis showed that 98 cases (30.91%) of all nodules were benign nodules and 219 cases (69.09%) were malignant nodules, and a further single-multivariate analysis showed that age, nodule maximum diameter, lobular sign, burr sign, vascular cluster sign, and pleural depression sign were independent relevant factors for the diagnosis of benign and malignant nodules. Conclusion. VATS is less invasive and has fewer complications and is of great clinical value for both diagnosis and treatment of benign and malignant SPN. Age, maximum nodal diameter, lobar sign, burr sign, vascular set sign, and pleural depression sign were independent correlates affecting the diagnosis of benign and malignant SPN, which reminds that great attention should be paid to patients who are older and have risk factors on imaging, and early and timely active treatment or close follow-up should be carried out.

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Section: Discussionmentioning

confidence: 99%

Clinical Analysis of Video-Assisted Thoracoscopic Surgery for Resection of Solitary Pulmonary Nodules and Influencing Factors in the Diagnosis of Benign and Malignant Nodules

Yue¹,

Fan

Zhang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…Recent studies have reported the usefulness of bronchoscopic marking. 21,22 Unlike percutaneous VATS marking, bronchoscopic marking does not damage the visceral pleura. Although bronchoscopic marking was not used in this study, the procedure is significantly superior to CT-guided percutaneous marking because of the lower incidence of iatrogenic pneumothorax.…”

Section: Discussionmentioning

confidence: 99%

“…It is advisable to prepare for thoracic drainage when placing a percutaneous VATS marker. Recent studies have reported the usefulness of bronchoscopic marking 21, 22 . Unlike percutaneous VATS marking, bronchoscopic marking does not damage the visceral pleura.…”

Section: Discussionmentioning

confidence: 99%

Contralateral pulmonary resection using selective bronchial blockade in postpneumonectomy patients

et al. 2020

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Background: Pulmonary resection is occasionally performed in postpneumonectomy patients with contralateral lung lesions, such as metachronous or metastatic lung cancer. Careful intraoperative respiratory management is essential in such patients. This study evaluated the respiratory management of postpneumonectomy patients who underwent contralateral pulmonary resection with selective bronchial blockade of the lobe or segment to be resected. Methods: We retrospectively analyzed the surgical findings and safety of surgery in six patients who underwent contralateral pulmonary resection with selective bronchial blockade after pneumonectomy for non-small cell lung cancer (NSCLC). Results: The percutaneous oxygen saturation did not decrease in any of the patients during bronchial blockade under high oxygen concentration. The median blockade time was 57.5 minutes. The operative field was tolerable secured under conditions of partial lung collapse, and partial pulmonary resection was performed as planned. Postoperatively, one patient developed acute respiratory distress syndrome due to acute exacerbation of interstitial pneumonia; however, no patients died within one month postoperatively. Two patients underwent pulmonary resection in order to obtain adequate tissue specimens to evaluate the biomarkers of multiple lung metastases. On histopathology, one patient tested positive for anaplastic lymphoma kinase (ALK) and was subsequently administered an ALK inhibitor, which prolonged survival. Conclusions: In all patients, intraoperative respiratory condition under partial lung collapse remained stable, and all partial pulmonary resections were safely performed. However, surgical indications should be carefully reviewed preoperatively in patients with interstitial pneumonia.

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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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Simultaneous cone beam computed tomography‐guided bronchoscopic marking and video‐assisted thoracoscopic wedge resection in a hybrid operating room

Cited by 11 publications

References 13 publications

Clinical Analysis of Video-Assisted Thoracoscopic Surgery for Resection of Solitary Pulmonary Nodules and Influencing Factors in the Diagnosis of Benign and Malignant Nodules

Clinical Analysis of Video-Assisted Thoracoscopic Surgery for Resection of Solitary Pulmonary Nodules and Influencing Factors in the Diagnosis of Benign and Malignant Nodules

Contralateral pulmonary resection using selective bronchial blockade in postpneumonectomy patients

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

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