Liu Xiaodan, Zhang Shusen, Li Honglin, Ren Xuezhu, Xu Xiaolan, Wang Xuejing, Ye Liyun, Cai Zhigang
The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Pulmonary and Critical Care Medicine, Affiliated Xing Tai People Hospital of Hebei Medical University, Xingtai, China.
Front Oncol. 2024 May 31;14:1396452. doi: 10.3389/fonc.2024.1396452. eCollection 2024.
The majority of patients of lung cancer have already lost the chance of surgery at the time of diagnosis. Percutaneous local thermal ablation is a precise minimally invasive technique and a viable alternative to surgical treatment. Compared with radiofrequency ablation and microwave ablation, percutaneous laser ablation for the treatment of lung tumors is less commonly used and reported, especially for primary lung cancer.
A 63-year-old male patient with mixed pulmonary nodules selected computed tomography-guided electromagnetic navigation system for percutaneous biopsy and laser ablation therapy. The puncture point was determined through Computed tomography scanning, along with the placement of the electromagnetic navigation system locators. After rapid on-site evaluation and pathological examination of the puncture tissue specimen, the diagnosis of lung adenocarcinoma was confirmed. A 980-nanometer wavelength semiconductor laser fiber was inserted into the appropriate position guided by the electromagnetic navigation system. Subsequently, a power of 7 watt was applied to ablate the tumor for 30 seconds, then pause for 60 seconds before repeating the procedure. Positron emission tomography-Computed tomography examination was performed 1 month after operation, suggesting complete response of the tumor.
Here, we present a case of percutaneous laser ablation treatment for primary lung cancer guided by computed tomography-electromagnetic navigation system. As a more precise, shorter duration, impedance-independent, safe and effective minimally invasive thermal ablation method, it is expected to gain wider application and become a novel alternative for surgical treatment.
大多数肺癌患者在确诊时已失去手术机会。经皮局部热消融是一种精确的微创技术,是手术治疗的可行替代方案。与射频消融和微波消融相比,经皮激光消融治疗肺部肿瘤的应用和报道较少,尤其是对于原发性肺癌。
一名63岁男性患者,有混合性肺结节,选择计算机断层扫描引导的电磁导航系统进行经皮活检和激光消融治疗。通过计算机断层扫描确定穿刺点,并放置电磁导航系统定位器。对穿刺组织标本进行快速现场评估和病理检查后,确诊为肺腺癌。在电磁导航系统引导下,将一根980纳米波长的半导体激光光纤插入合适位置。随后,以7瓦功率消融肿瘤30秒,然后暂停60秒,再重复该过程。术后1个月进行正电子发射断层扫描-计算机断层扫描检查,提示肿瘤完全缓解。
在此,我们展示了一例在计算机断层扫描-电磁导航系统引导下对原发性肺癌进行经皮激光消融治疗的病例。作为一种更精确、持续时间更短、与阻抗无关、安全有效的微创热消融方法,有望得到更广泛的应用,并成为手术治疗的一种新选择。