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电磁导航支气管镜引导下微波消融治疗多发性肺结节:单中心研究。

Application of electromagnetic navigation bronchoscopy-guided microwave ablation in multiple pulmonary nodules: a single-centre study.

机构信息

Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China.

出版信息

Eur J Cardiothorac Surg. 2022 Sep 2;62(4). doi: 10.1093/ejcts/ezac071.

Abstract

OBJECTIVES

Electromagnetic navigation bronchoscopy (ENB)-guided microwave ablation is a minimally invasive technology for treating pulmonary lesions. This study analysed the short-term safety and efficacy of ENB-guided microwave ablation in multiple pulmonary nodules (MPNs).

METHODS

This retrospective study reports a single-centre experience with ENB-guided microwave ablation for MPNs. Clinical, surgical and pathological data were obtained for patients who underwent ENB-guided microwave ablation from 23 December 2019 to 23 June 2021. The primary end points were technical safety and efficiency.

RESULTS

The study assessed 65 patients who underwent ENB-guided microwave ablation, 57 of whom simultaneously underwent video-assisted thoracic surgery. In total, 216 nodules were treated. Of 96 nodules treated by ENB-guided microwave ablation, 94 nodules had ground-glass opacity. Ablation efficiency was confirmed by hybrid cone-beam computed tomography. Of 120 nodules surgically removed, 106 nodules had ground-glass opacity. The mean nodule size was 7.9 mm in ablated nodules and 10.2 mm in resected nodules. Distance between nodules and pleura or fissure was 17.45 mm in ablated nodules and 7.29 mm in resected nodules. The overall malignancy rate was 47.7% (103/216); the complication rate was low (65 patients). At short-term follow-up, the post-ablation target zone shrank by 1 week and stabilized after 4-6 months. No local recurrence or enlargement of other pulmonary nodules was noted.

CONCLUSIONS

To treat MPNs, ENB-guided microwave ablation is safe and efficient. The combination of this treatment and video-assisted thoracic surgery is a potential application, which can preserve as much pulmonary function as possible and treat MPNs to the maximum extent.

摘要

目的

电磁导航支气管镜(ENB)引导下微波消融是一种治疗肺部病变的微创技术。本研究分析了 ENB 引导下微波消融治疗多发性肺结节(MPN)的短期安全性和有效性。

方法

这是一项回顾性研究,报告了 2019 年 12 月 23 日至 2021 年 6 月 23 日期间,在单一中心接受 ENB 引导下微波消融治疗 MPN 的患者的临床、手术和病理数据。主要终点是技术安全性和效率。

结果

该研究评估了 65 例接受 ENB 引导下微波消融的患者,其中 57 例同时接受了电视辅助胸腔镜手术。总共治疗了 216 个结节。在 96 个接受 ENB 引导下微波消融治疗的结节中,94 个结节为磨玻璃样密度。通过混合锥形束 CT 确认消融效率。在 120 个手术切除的结节中,106 个为磨玻璃样密度。消融结节的平均直径为 7.9mm,切除结节的平均直径为 10.2mm。消融结节与胸膜或裂之间的距离为 17.45mm,切除结节的距离为 7.29mm。总的恶性率为 47.7%(103/216);并发症发生率较低(65 例)。短期随访显示,消融后靶区在 1 周内缩小,4-6 个月后稳定。未发现局部复发或其他肺结节增大。

结论

对于 MPN 的治疗,ENB 引导下微波消融是安全有效的。这种治疗方法与电视辅助胸腔镜手术的结合是一种潜在的应用,可以尽可能地保留肺功能,并最大限度地治疗 MPN。

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