The use of electromagnetic navigation bronchoscopy-guided microwave ablation in patients with multiple bilateral pulmonary nodules: a retrospective study of 26 cases.

BACKGROUND

To treat multiple bilateral ground-glass opacities (GGOs), surgical treatments and electromagnetic navigation bronchoscopy (ENB)-guided ablation therapy are recommended therapeutic measures. However, the differences between bilateral and unilateral ablation, with or without surgery, remain unknown. This study aims to evaluate the differences in efficacy among various strategies.

METHODS

This retrospective study reports a single-center experience with ENB-guided microwave ablation (MWA) for patients with multiple bilateral GGOs. A total of 26 cases from December 2020 to February 2023 were reviewed. The primary end points were technical safety and efficiency.

RESULTS

This study compared three therapeutic strategies for patients with multiple bilateral GGOs based on ENB-guided MWA. Five cases simultaneously underwent video-assisted thoracoscopic surgery (VATS) and ENB-guided MWA, namely simultaneous VATS-MWA group. Eight cases received VATS followed by the second period ENB-guided MWA, namely two-step VATS-MWA group. Thirteen cases were performed with only ENB-guided MWA for bilateral lesions. All conducted treatments were consistent with preoperative assessment. The group of only ENB-guided MWA had the worst pulmonary function and performance status but the highest proportion of pure GGOs. Intriguingly, the use of only ENB-guided MWA showed a favorable performance in pathological detection, while no significant differences were found between the simultaneous VATS-MWA group and the two-step VATS-MWA group.

CONCLUSIONS

The use of ENB-guided MWA shows efficacy in treating multiple bilateral GGOs suspected of having multiple primary lung cancers. Bilateral ENB-guided MWA is feasible in patients who cannot tolerate surgery, and VATS combined with ENB-guided MWA is safe and can also preserve as much pulmonary function as possible.