Zhang Jie, He Jiaxi, Chen Jianfeng, Zhong Yunpeng, He Jianxing, Li Shuben
Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China.
Transl Lung Cancer Res. 2021 Dec;10(12):4414-4422. doi: 10.21037/tlcr-21-699.
Accurate localization of pulmonary nodules becomes a crucial step in diagnosis and treatment. However, the efficacy and accuracy of electromagnetic navigation bronchoscopy (ENB)-guided localization with indocyanine green (ICG) injection for video-assisted thoracoscopic surgery (VATS) lung resection remain unclear.
A retrospective study was performed that patients who had small pulmonary nodules and underwent lung resection after ENB-guided localization were included from Oct 2018 to Mar 2021. The analysis of the efficacy and accuracy of ENB-guided localization was conducted.
A total of 181 pulmonary nodules in 173 patients were recorded which were 9.21±4.81 mm in size. The mean time of ENB-guided localization was 7.99±4.9 minutes. The success rate of nodule localization was 98.3% (178/181), while the accuracy was 89% (161/181) without any complication. All patients received thoracoscopic surgery after localization, and all nodules were completely resected. A customized scoring system was used to evaluate localization accuracy, and the patients were divided into four groups according to it. The localization accuracy was positively associated with the bronchus sign (P<0.001) and negatively with the location of the nodule (anterior segment and superior lingual segment of left upper lobe) (P=0.013 and 0.03, respectively).
ENB-guided pulmonary nodule localization by ICG injection is an accurate and effective method with a short operation time and few complications, which could be widely used in clinical practice.
肺结节的准确定位成为诊断和治疗的关键步骤。然而，对于电视辅助胸腔镜手术（VATS）肺切除术中，经电磁导航支气管镜（ENB）引导并注射吲哚菁绿（ICG）进行定位的有效性和准确性仍不明确。
进行一项回顾性研究，纳入2018年10月至2021年3月间有小肺结节并在ENB引导定位后接受肺切除的患者。对ENB引导定位的有效性和准确性进行分析。
共记录了173例患者的181个肺结节，大小为9.21±4.81毫米。ENB引导定位的平均时间为7.99±4.9分钟。结节定位成功率为98.3%（178/181），准确性为89%（161/181），且无任何并发症。所有患者在定位后均接受了胸腔镜手术，所有结节均被完整切除。使用定制的评分系统评估定位准确性，并据此将患者分为四组。定位准确性与支气管征呈正相关（P<0.001），与结节位置（左上叶前段和舌叶上段）呈负相关（分别为P=0.013和0.03）。
经ENB引导通过ICG注射进行肺结节定位是一种准确有效的方法，手术时间短且并发症少，可在临床实践中广泛应用。
