Intraoperative marking of pulmonary nodules in a hybrid operating room: electromagnetic navigation bronchoscopy versus percutaneous marking.

Autor:	Gómez-Hernández MT; Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain.; Salamanca Institute of Biomedical Research, Salamanca, Spain.; Department of Surgery, University of Salamanca, Salamanca, Spain., Rivas Duarte CE; Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain.; Salamanca Institute of Biomedical Research, Salamanca, Spain.; Department of Surgery, University of Salamanca, Salamanca, Spain., Fernández García-Hierro JM; Service of Radiology, Salamanca University Hospital, Salamanca, Spain., Fuentes MG; Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain.; Salamanca Institute of Biomedical Research, Salamanca, Spain.; Department of Surgery, University of Salamanca, Salamanca, Spain., Colmenares O; Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain.; Salamanca Institute of Biomedical Research, Salamanca, Spain., Forcada Barreda C; Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain., Gómez Valle F; Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain., Jiménez García I; Service of Radiology, Salamanca University Hospital, Salamanca, Spain., Jiménez MF; Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain.; Salamanca Institute of Biomedical Research, Salamanca, Spain.; Department of Surgery, University of Salamanca, Salamanca, Spain.
Jazyk:	angličtina
Zdroj:	Frontiers in surgery [Front Surg] 2024 Sep 30; Vol. 11, pp. 1482120. Date of Electronic Publication: 2024 Sep 30 (Print Publication: 2024).
DOI:	10.3389/fsurg.2024.1482120
Abstrakt:	Background: Intraoperative identification of subsolid or small pulmonary nodules during minimally invasive procedures is challenging. Recent localization techniques show varying success and complications. Hybrid operating rooms (HORs), equipped with radiological tools, facilitate intraoperative imaging. This study compares the accuracy and safety of marking pulmonary nodules using electromagnetic navigation bronchoscopy (ENB) combined with Cone Beam Computed Tomography (CBCT) vs. CBCT-guided percutaneous marking (PM). Methods: This retrospective cohort study included patients with pulmonary nodules scheduled for minimally invasive resection in a HOR. Marking techniques included ENB assisted by CBCT and PM guided by CBCT. The study compared the success rate, procedure time, intraoperative complications and radiation dose of both techniques. Results: A total of 104 patients with 114 nodules were included (October 2021-July 2024). Thirty nodules were marked using ENB, and 84 with PM. One case used both techniques due to ENB failure. No differences among groups were found in nodule characteristics. Success rates were similar (93.3% in ENB group vs. 91.7% in PM group, p  = 1). Marking took significantly longer time in the ENB group (median 40 min) compared to PM group (25 min, p  = 0.007). Five (6%) patients in the PM group experienced intraoperative complications compared to none in the ENB ( p  = 0.323). Radiation dose was significantly higher in the ENB group ( p  = 0.002). Conclusions: ENB assisted by CBCT is a safe and effective technique, with success rates comparable to CBCT-guided PM, though it may result in longer procedural times and higher radiation doses. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision. (© 2024 Gómez-Hernández, Rivas Duarte, Fernández García-Hierro, Fuentes, Colmenares, Forcada Barreda, Gómez Valle, Jiménez García and Jiménez.)
Databáze:	MEDLINE
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