Intraoperative lung ultrasound improves subcentimetric pulmonary nodule localization during VATS: Results of a retrospective analysis.

Autor: Gambardella C; Division of General, Oncological, Mini-invasive and Obesity Surgery, University of Study of Campania 'Luigi Vanvitelli', Naples, Italy., Messina G; Thoracic Surgery Unit, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Pica DG; Thoracic Surgery Unit, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Bove M; Thoracic Surgery Unit, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Capasso F; Thoracic Surgery Unit, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Mirra R; Thoracic Surgery Unit, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Natale G; Thoracic Surgery Unit, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., D'Alba FP; Thoracic Surgery Unit, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Caputo A; Thoracic Surgery Unit, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Leonardi B; Thoracic Surgery Unit, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Puca MA; Thoracic Surgery Unit, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Giorgiano NM; Thoracic Surgery Unit, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Pirozzi M; Oncology, Department of Precision Medicine, Università della Campania 'L. Vanvitelli', Naples, Italy., Farese S; Oncology, Department of Precision Medicine, Università della Campania 'L. Vanvitelli', Naples, Italy., Zotta A; Oncology, Department of Precision Medicine, Università della Campania 'L. Vanvitelli', Naples, Italy., Miele F; General Surgery Unit, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Vicidomini G; Thoracic Surgery Unit, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Docimo L; Division of General, Oncological, Mini-invasive and Obesity Surgery, University of Study of Campania 'Luigi Vanvitelli', Naples, Italy., Fiorelli A; Thoracic Surgery Unit, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Ciardiello F; Oncology, Department of Precision Medicine, Università della Campania 'L. Vanvitelli', Naples, Italy., Fasano M; Oncology, Department of Precision Medicine, Università della Campania 'L. Vanvitelli', Naples, Italy.
Jazyk: angličtina
Zdroj: Thoracic cancer [Thorac Cancer] 2023 Sep; Vol. 14 (25), pp. 2558-2566. Date of Electronic Publication: 2023 Jul 20.
DOI: 10.1111/1759-7714.15027
Abstrakt: Background: Video-assisted thoracoscopic surgery (VATS) resection of deep-seated lung nodules smaller than 1 cm is extremely challenging. Several methods have been proposed to overcome this limitation but with not neglectable complications. Intraoperative lung ultrasound (ILU) is the latest minimally invasive proposed technique. The aim of the current study was to analyze the accuracy and efficacy of ILU associated with VATS to visualize solitary and deep-seated pulmonary nodules smaller than 1 cm.
Methods: Patients with subcentimetric solitary and deep-seated pulmonary nodules were included in this retrospective study from November 2020 to December 2022. Patients who received VATS aided with ILU were considered as group A and patients who received conventional VATS as group B (control group). The rate of nodule identification and the time for localization with VATS alone and with VATS aided with ILU in each group were analyzed.
Results: A total of 43 patients received VATS aided with ILU (group A) and 31 patients received conventional VATS (group B). Mean operative time was lower in group A (p < 0.05). In group A all the nodules were correctly identified, while in group B in one case the localization failed. The time to identify the lesion was lower in group A (7.1 ± 2.2 vs. 13.8 ± 4.6; p < 0.05). During hospitalization three patients (6.5%; p < 0.05) in group B presented air leaks that were conservatively managed.
Conclusion: Intracavitary VATS-US is a reliable, feasible, real-time and effective method of localization of parenchymal lung nodules during selected wedge resection procedures.
(© 2023 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje