Author of

• 20165

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  P1.16 - Surgery (ID 702)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 22818

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    P1.16-016 - Comparing Safety and Effectiveness of Image-Guided VATS Versus Conventional VATS for Small or Deep Pulmonary Nodules (ID 9300)

    09:30 - 16:00  |  Presenting Author(s): Yin Kai Chao
    • Abstract

    Background:
    Video-assisted thoracic surgery (VATS) is currently performed to diagnose and treat solitary pulmonary nodules (SPN). However, the intra-operative identification of small and/or deep nodules can be challenging with VATS as the lung is difficult to palpate. Single-stage image-guided VATS(iVATS) performed in a hybrid operation room has been introduced in recent years for the simultaneous localization and removal of small SPN. However, its efficacy and safety compared with traditional workflow has not been studied.
    
    Method:
    Patients with undiagnosed SPN who required tumor localization prior to surgical resection between 2017/3 to 2017/6 were retrospectively reviewed. Based on the type of tumor localization method , patients were divided into two groups( Group1 : iVATS ; Group 2: preoperative computed tomography guide tumor localization followed by VATS). The efficacy in localizing the tumor, complications, necessity to convert VATS to thoracotomy and radiation dose were compared.
    
    Result:
    The cohort comprised 24 patients(12 in each group). The median SPN diameter was 7 mm (range: 3 – 11 mm) and the median distance of the lesion from the pleural surface was 13 mm (range: 0 – 47 mm) with no intergroup difference(P>0.05). Tumor localization procedure was successful in all patients with similar procedure time( group1: 28 mins[range: 16~41 mins] ; group2: 20 mins[range:14-35 mins] , p>0.05). However, the time interval from completion of localization to surgery was significantly longer in group2(median: 159 mins[range:78~313mins]) than in group1(median:10mins[range:3~20 mins], p<0.001). In group 2, migration of the hook wire occurred in 1 patients during the waiting period although it did not affect the success of VATS resection (nodule location guided by the lung puncture site). The mean effective radiation dose for group1 was 11.53 mSv and that for group2 was 13.50 mSv, respectively(P>0.05) .
    
    Conclusion:
    Compared with the traditional workflow(based on preoperative CT-guided lesion localization followed by its surgical removal), single-stage iVATS for simultaneous localization and removal of small SPN is equally safe and accurate but more efficient .