Chang Aliss T C, Chan Joyce W Y, Siu Ivan C H, Lau Rainbow W H, Chu Cheuk Man, Mok Tony S K, Ng Calvin S H
Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Interdiscip Cardiovasc Thorac Surg. 2025 Jul 3;40(7). doi: 10.1093/icvts/ivaf152.
Transbronchial microwave ablation may have additional value when performed with the same-session lung resection or in patients with a history of lung resection(s). We present our institutional cohort to assess the feasibility and safety of transbronchial microwave ablation with the presence of lung resection.
From March 2019 to February 2024, 92 patients who underwent transbronchial microwave ablation with either a history of major lung resection(s) or same-session ablation with concomitant video-assisted thoracoscopic lung resection(s) were included in this study. Procedural details, safety outcomes and length of stay were retrospectively analysed.
There were 103 episodes of transbronchial microwave ablation performed, and 142 lung lesions were ablated. The average size of nodules was 11.80 mm. Technical success was 100% with a mean minimum margin of 6 mm. Complications occurred in 23 procedures; the majority were CTCAE grade 1 complications (74%), which resolved shortly with observation, and the rest were grade 2 and 3 complications (13%), including one case of bronchopleural fistula and two cases of pneumothorax that required drainage. The average length of stay was 1.46 days. A total of 11 cases of same-session ablation with lung resection were performed. The average procedural time was 226 min, which is significantly shorter than the 27 cases of separate surgery and ablation during the same period (P = 0.012).
Performing transbronchial microwave ablation utilizing electromagnetic navigation bronchoscopic guidance is feasible and safe in the background of lung resection. This technique can also be incorporated into a one-stop treatment with concomitant lung resection.
在同期肺切除或有肺切除史的患者中进行经支气管微波消融可能具有额外价值。我们展示我们机构的队列研究以评估在存在肺切除的情况下经支气管微波消融的可行性和安全性。
2019年3月至2024年2月，本研究纳入了92例有大肺切除史或同期进行电视辅助胸腔镜肺切除并经支气管微波消融的患者。对手术细节、安全结果和住院时间进行回顾性分析。
共进行了103次经支气管微波消融，消融了142个肺病灶。结节平均大小为11.80毫米。技术成功率为100%，平均最小切缘为6毫米。23例手术出现并发症；大多数为CTCAE 1级并发症（74%），经观察很快缓解，其余为2级和3级并发症（13%），包括1例支气管胸膜瘘和2例需要引流的气胸。平均住院时间为1.46天。共进行了11例同期肺切除并消融手术。平均手术时间为226分钟，明显短于同期27例单独手术和消融（P = 0.012）。
在肺切除背景下，利用电磁导航支气管镜引导进行经支气管微波消融是可行且安全的。该技术也可纳入同期肺切除的一站式治疗。
