Electromagnetic navigation bronchoscopic localization versus percutaneous CT ‐guided localization for thoracoscopic resection of small pulmonary nodules

作者：Yanlong Yang, Zizhe Li, Weichao Huang, Zhuang Jia, Daiying Lin, Wen‐Zhao Zhong, Bin Lan · 发表于：Thoracic Cancer · 年份：2021 · DOI：10.1111/1759-7714.13775 · 被引用次数：38 · 研究领域：Lung Cancer Diagnosis and Treatment、Pleural and Pulmonary Diseases、Advanced Radiotherapy Techniques

BACKGROUND: Identification of small pulmonary nodules is challenging in a limited intrathoracic field during minimally invasive video-assisted thoracoscopic surgery (VATS), and preoperative localization is required. Various techniques have been reported with some failure and complications. Here, we compare the feasibility and safety between electromagnetic navigation bronchoscopic marking and computed tomography (CT)-guided percutaneous marking using indocyanine green (ICG) and iopamidol. METHODS: A total of 47 patients with small-sized pulmonary nodules, scheduled to undergo video-assisted thoracoscopic limited resection, were enrolled in this study. A mixture of diluted ICG and iopamidol was injected into the lung parenchyma as a marker, using CT-guided percutaneous or electromagnetic navigation bronchoscopic injection techniques and the results were examined and compared. RESULTS: A total of 35 and 12 patients underwent preoperative marking by percutaneous injection and electromagnetic navigation bronchoscopic injection, respectively, in which a marker was detected in 33/35 (94.3%) and 12/12 (100%) patients. No combination of these procedures was performed in any patient. All markers were successfully detected in three patients who underwent injection marking at two different lesion sites. Pneumothorax occurred in five patients (14%) in the percutaneous marking group, which was relieved in all patients without the necessity for chest tube drainage. No other complication wa...