Bolton William David, Cochran Thomas, Ben-Or Sharon, Stephenson James E, Ellis William, Hale Allyson L, Binks Andrew P
From the *Division of Surgical Oncology, Department of Surgery, Greenville Health System, Greenville, SC USA; and †University of South Carolina School of Medicine-Greenville, Greenville, SC USA.
Innovations (Phila). 2017 Sep/Oct;12(5):333-337. doi: 10.1097/IMI.0000000000000387.
The aims of the study were to evaluate electromagnetic navigational bronchoscopy (ENB) and computed tomography-guided placement as localization techniques for minimally invasive resection of small pulmonary nodules and determine whether electromagnetic navigational bronchoscopy is a safer and more effective method than computed tomography-guided localization.
We performed a retrospective review of our thoracic surgery database to identify patients who underwent minimally invasive resection for a pulmonary mass and used either electromagnetic navigational bronchoscopy or computed tomography-guided localization techniques between July 2011 and May 2015.
Three hundred eighty-three patients had a minimally invasive resection during our study period, 117 of whom underwent electromagnetic navigational bronchoscopy or computed tomography localization (electromagnetic navigational bronchoscopy = 81; computed tomography = 36). There was no significant difference between computed tomography and electromagnetic navigational bronchoscopy patient groups with regard to age, sex, race, pathology, nodule size, or location. Both computed tomography and electromagnetic navigational bronchoscopy were 100% successful at localizing the mass, and there was no difference in the type of definitive surgical resection (wedge, segmentectomy, or lobectomy) (P = 0.320). Postoperative complications occurred in 36% of all patients, but there were no complications related to the localization procedures. In terms of localization time and surgical time, there was no difference between groups. However, the down/wait time between localization and resection was significant (computed tomography = 189 minutes; electromagnetic navigational bronchoscopy = 27 minutes); this explains why the difference in total time (sum of localization, down, and surgery) was significant (P < 0.001).
We found electromagnetic navigational bronchoscopy to be as safe and effective as computed tomography-guided wire placement and to provide a significantly decreased down time between localization and surgical resection.
本研究旨在评估电磁导航支气管镜检查（ENB）和计算机断层扫描引导下放置作为小肺结节微创切除的定位技术，并确定电磁导航支气管镜检查是否比计算机断层扫描引导下定位更安全、更有效。
我们对胸外科数据库进行了回顾性研究，以确定在2011年7月至2015年5月期间接受肺肿块微创切除并使用电磁导航支气管镜检查或计算机断层扫描引导下定位技术的患者。
在我们的研究期间，383例患者接受了微创切除，其中117例接受了电磁导航支气管镜检查或计算机断层扫描定位（电磁导航支气管镜检查=81例；计算机断层扫描=36例）。在年龄、性别、种族、病理、结节大小或位置方面，计算机断层扫描和电磁导航支气管镜检查患者组之间没有显著差异。计算机断层扫描和电磁导航支气管镜检查在定位肿块方面均100%成功，在确定性手术切除类型（楔形切除、肺段切除或肺叶切除）方面没有差异（P=0.320）。所有患者中有36%发生了术后并发症，但没有与定位程序相关的并发症。在定位时间和手术时间方面，两组之间没有差异。然而，定位和切除之间的停机/等待时间有显著差异（计算机断层扫描=189分钟；电磁导航支气管镜检查=27分钟）；这解释了为什么总时间（定位、停机和手术时间之和）的差异显著（P<0.001）。
我们发现电磁导航支气管镜检查与计算机断层扫描引导下的导丝放置一样安全有效，并且在定位和手术切除之间的停机时间显著缩短。
