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Taisuke Kaiho



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    P04 - Early Stage/Localized Disease - Perioperative Therapy (Neoadjuvant Therapy, Surgery, Adjuvant Therapy) (ID 113)

    • Event: WCLC 2020
    • Type: Posters
    • Track: Early Stage/Localized Disease
    • Presentations: 1
    • Moderators:
    • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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      P04.09 - Real-Time CT Guided Video-Assisted Thoracoscopic Partial Resection of Peripheral Small-Sized Lung Tumors in Hybrid OR –A Phase 2 Trial– (ID 1022)

      00:00 - 00:00  |  Presenting Author(s): Taisuke Kaiho

      • Abstract
      • Slides

      Introduction

      This study aims to evaluate the feasibility and safety of real-time CT guided video-assisted thoracoscopic (VATS) partial resection for impalpable small pulmonary nodules. Lung cancer or malignancy suspected lesions were eligible if the lesions were defined as GGO-dominant (>50%) tumor with a diameter of 3cm or lower (GGO-dominant type), or tumor of 2cm or lower which was located deeper than the diameter of the tumor from visceral pleura (Deep solid type).

      Methods

      This single-center phase 2 trial was performed between April in 2018 and March in 2019. First, several surgical clips (first markers) were put on the visceral pleura nearly around the tumor through 3-ports VATS approach. The location information between the concerned tumor and the first markers were obtained by cone-beam CT (CBCT), and then the second marker was put just on the tumor based on the image. Pulmonary resection was performed according to the second marker guided by automated staplers. The primary endpoint was complete macroscopic resection rate, and secondary endpoints were complete microscopic resection rate and safety.wclc2020 figure.jpg

      Results

      The 22 nodules of 9 men and 11 women with a mean age of 64.3 years were eligible. The tumors were located in the right upper/middle/lower lobe in 3/1/5 patients and the left upper/lower lobe in 5/8 patients. Seven nodules (31.8%) were GGO-dominant types and 15 nodules (68.2%) were deep solid types. CBCT clearly could detect all nodules. The mean localization time was 17.4 (90%CI, 14.5-20.2) minutes, and mean operation time was 110.7 (90%CI, 96.4-125.0) minutes. Complete macroscopic resection was accomplished in 19 patients (95.0%, p=0.047), and all patients accomplished complete microscopic resection. Postoperative air leakage and bleeding were observed in one respectively (5%).table1.jpeg

      Conclusion

      CBCT is a safe and useful guide for VATS partial resection for impalpable peripheral pulmonary nodules.

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