Chang Chia-Jung, Lu Chi-Hsuan, Gao Xing, Fang Hsin-Yueh, Chao Yin-Kai
Division of Thoracic Surgery, Chang Gung Memorial Hospital-Linkou, Chang Gung University, Taoyuan 333423, Taiwan.
Life (Basel). 2022 Mar 28;12(4):494. doi: 10.3390/life12040494.
Preoperative localization holds promise for overcoming the limitations of video-assisted thoracoscopic surgery (VATS) in the treatment of impalpable lung nodules. The purpose of this study was to assess the safety and efficacy of cone-beam computed tomography (CBCT)-guided localization using near-infrared (NIR) marking. Between 2017 and 2021, patients presenting with a solitary pulmonary nodule (SPN) who had undergone CBCT-guided lesion localization with indocyanine green (ICG) in a hybrid operating room were included. The primary outcomes were the efficacy of localization and the occurrence of complications. The study cohort consisted of 175 patients with the mean age of 58.76 years. The mean size and depth of the 175 SPNs were 8.34 mm and 5.3 mm, respectively. The mean time required for lesion marking was 14.71 min. Upon thoracoscopic inspection, the NIR tattoo was detected in the vast majority of the study participants (98.3%). An utility thoracotomy to allow digital palpation was required in two of the three patients in whom the tattoo was not identifiable. The perioperative survival rate was 100%, and the mean length of hospital stay was 3.09 days. We conclude that needle localization with ICG injection is a safe and feasible technique to localize SPNs prior to resection.
术前定位有望克服电视辅助胸腔镜手术（VATS）在治疗不可触及肺结节方面的局限性。本研究的目的是评估锥束计算机断层扫描（CBCT）引导下使用近红外（NIR）标记进行定位的安全性和有效性。在2017年至2021年期间，纳入了在杂交手术室接受CBCT引导下吲哚菁绿（ICG）病变定位的孤立性肺结节（SPN）患者。主要结局是定位的有效性和并发症的发生情况。研究队列包括175例患者，平均年龄为58.76岁。175个SPN的平均大小和深度分别为8.34毫米和5.3毫米。病变标记所需的平均时间为14.71分钟。胸腔镜检查时，绝大多数研究参与者（98.3%）检测到NIR纹身。在三个无法识别纹身的患者中，有两个需要进行实用开胸手术以进行数字触诊。围手术期生存率为100%，平均住院时间为3.09天。我们得出结论，ICG注射针定位是在切除术前定位SPN的一种安全可行的技术。
