Efficacy and safety of artificial pneumothorax with position adjustment for CT‐guided percutaneous transthoracic microwave ablation of small subpleural lung tumors

Jia, Haipeng; Tian, Jie; Liu, Bo; Meng, Hong; Pan, Fengmin; Li, Chunhai

doi:10.1111/1759-7714.13137

Cited by 16 publications

(7 citation statements)

References 26 publications

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“…After completion of the ablation, the instilled air is removed using the same centesis catheter needle, which is kept in place during the procedure to quickly remove the air if needed. 32 The procedure can be done under sedation or general anesthesia, with preference for general anesthesia in some centers, as it is thought to improve the technique's feasibility, particularly in technically challenging cases where organ displacement or specific patient positioning is required. 20 Under CT guidance, real-time or stepwise according to the operator preference, the microwave applicator (or applicators) is advanced into the lesion.…”

Section: Techniquementioning

confidence: 99%

Microwave Ablation in Primary Lung Malignancies

Moussa

Ziv

Solomon

et al. 2019

Semin intervent Radiol

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Lung cancer is the leading cause of cancer-related mortality worldwide. Eighty-five percent of cases correspond to non-small cell lung cancer (NSCLC) and pivotal nonsurgical options for early-stage disease include percutaneous ablation and stereotactic body radiation therapy (SBRT). Microwave Ablation (MWA) is a locoregional treatment option that has many advantages over radiofrequency ablation and has been able to overcome the limitations of this technique in the treatment of early-stage NSCLC. In this review article, we highlight the current evidence supporting the use of MWA in patients with early-stage NSCLC and discuss the technical considerations of the procedure, including optimal patient selection and planning strategies, as well as the potential complications and reported outcomes. Finally, we mention future trends involving ablation in NSCLC, including its role in combination with SBRT in central tumors, management of post-SBRT local recurrence, and its potential as an adjuvant treatment option for patients with resistance to systemic therapy or in combination with checkpoint inhibitors.

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Section: Techniquementioning

confidence: 99%

Microwave Ablation in Primary Lung Malignancies

Moussa

Ziv

Solomon

et al. 2019

Semin intervent Radiol

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“…However, bronchopleural fistula after ablation of the central tumor may not be closed easily by drainage and anti-infective treatment alone, which requires early surgical intervention. On the other hand, previous studies have shown no significant difference in technical success, technical efficacy, local tumor control, and complications with artificial pneumothorax compared with no artificial pneumothorax (32). Although studies have shown that artificial air/hydrothorax can reduce pain in patients (33), it does not reduce the occurrence of bronchopleural fistula.…”

Section: Discussionmentioning

confidence: 91%

Local ablation of pulmonary malignancies abutting pleura: Evaluation of midterm local efficacy and safety

Zhao

Guo

et al. 2022

Front. Oncol.

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ObjectiveTo retrospectively evaluate the efficacy and safety of local ablation treatment for adjacent pleural lung tumors.Materials and methodsSixty-two patients who underwent pulmonary nodule ablation at the Affiliated Cancer Hospital of Zhengzhou University were enrolled between January 2016 and December 2020. All patients were followed up with enhanced computed tomography or magnetic resonance imaging within 48 h after treatment and 2, 4, 6, 9, and 12 months after treatment. All patients were followed for at least 12 months.ResultsA total of 84 targeted tumors (62 patients) underwent 94 ablations. In the 12-month follow-up images, 69 of the 84 targeted tumors were completely ablated, 15 had incomplete ablation, and the 12-month incomplete ablation rate was 17.8% (15/84). Of the 15 incompletely ablated tumors, six had partial responses, five had stable disease, and four had progressive disease. The most common adverse event was pneumothorax, with an incidence of 54.8% (34/62). The second most common complication was pleural effusion, with an incidence rate of 41.9% (26/62). The incidence of needle-tract bleeding was 21% (13/62) and all patients were cured using hemostatic drugs. Serious complications were bronchopleural fistula in four patients (6.5%, 4/62) and needle tract metastasis in one patient. Four cases of bronchopleural fistula were found in the early stages and were cured after symptomatic treatment.ConclusionLocal ablation is effective for the treatment of adjacent pleural lung tumors, and its operation is safe and controllable.

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“…All patients were evaluated before, during, and after the MWA procedure using a visual analog scale (VAS) system, which was applied in previous literature (16)(17)(18). The patients were scored and recorded on the VAS scale before, during, and 24 hours after the procedure to compare the differences in pain degrees between the two groups.…”

Section: Pain Assessmentmentioning

confidence: 99%

Microwave ablation with local pleural anesthesia for subpleural pulmonary nodules: our experience

Meng

Zhang

et al. 2022

Front. Oncol.

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ObjectivesTo explore the efficacy and safety of local pleural anesthesia (LPA) for relieving pain during microwave ablation (MWA) of pulmonary nodules in the subpleural regions.Materials and MethodsFrom June 2019 to December 2021, 88 patients with 97 subpleural nodules underwent percutaneous CT-guided MWA. Patients were divided into two groups according to whether LPA was applied; 53 patients with local pleural anesthesia during MWA; and 35 patients with MWA without LPA. The differences in technical success, pre-and post- and intra-operative visual analog scale (VAS) pain scores, complications of the procedure, and local progression-free survival (LPFS) between the two groups were assessed. Thus, to evaluate the efficacy and safety of MWA combined with LPA for treating subpleural nodules.ResultsIn this study, the procedures in all patients of both groups achieved technical success according to pre-operative planning. There was no statistically significant difference in the pre-operative VAS pain scores between the two groups. Intra-operative VAS scores were significantly higher in the non-LPA (NLPA) group than in the LPA group. They remained significantly higher in the NLPA group than in the LPA group during the short postoperative period. Analgesics were used more in the NLPA group than in the LPA group intra- and postoperatively, with a statistically significant difference, especially during the MWA procedures. The overall LPFS rates were 100%, 98.333%, 98.333%, and 98.333% at 1, 3, 6, and 12 months postoperatively in the LPA group and 100%, 97.297%, 94.595%, and 94.595% postoperatively in the NLPA group, respectively. Tumor recurrence occurred in one and two patients with lung adenocarcinoma in the LPA and NLPA groups. The incidence of pneumothorax was significantly higher in the NLPA group (25,714%, 9/35) than in the LPA group (15.094%, 8/53), and there were three cases of pleural effusion (blood collection) and one case of pulmonary hemorrhage in the NLPA group.ConclusionPercutaneous CT-guided MWA is a safe and effective treatment for subpleural pulmonary nodules. Applying a combined LPA technique can reduce the patient’s pain and complications during and after the MWA. The long-term efficacy must be verified in more patients and a longer follow-up.

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Efficacy and safety of artificial pneumothorax with position adjustment for CT‐guided percutaneous transthoracic microwave ablation of small subpleural lung tumors

Cited by 16 publications

References 26 publications

Microwave Ablation in Primary Lung Malignancies

Microwave Ablation in Primary Lung Malignancies

Local ablation of pulmonary malignancies abutting pleura: Evaluation of midterm local efficacy and safety

Microwave ablation with local pleural anesthesia for subpleural pulmonary nodules: our experience

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