Intraoperative imaging and localization techniques for part-solid nodules

Su, Katherine W.; Singhal, Sunil; Sarkaria, Inderpal S.

doi:10.1016/j.xjtc.2021.10.028

Cited by 3 publications

(2 citation statements)

References 33 publications

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“…This is enhanced by the low sensitivity of imaging in picking up pulmonary metastases [12,13]. The previous concept has been challenged by five factors: i) advances in imaging modalities with thin-slice cuts which can detect nodules smaller than 2-5 mm [14], ii) advances in pre-and intra-operative localization techniques in hybrid operating rooms facilitating identification of all image-detectable lesions [15], iii) not all detectable lesions are found to be malignant [7,16], iv) enhanced recovery offered by minimally invasive VATS procedures [17,18] which enables faster initiation of adjuvant therapy (integral part of disease management), and v) the lack of survival benefit of OT over VATS has been consistently shown in many reports [19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Role of video-assisted thoracoscopic surgery in pulmonary metastasectomy

Elkhayat¹,

Hamza²,

Elshoieby³

et al. 2022

kitp

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Introdcution: There are sparse prospective studies investigating the role of video-assisted thoracoscopic surgery (VATS) in management of pulmonary metastasis. Aim: To prospectively investigate short-term surgical and pathological outcomes for PM patients operated on by VATS or open thoracotomy (OT) for management of lung secondaries. Material and methods: Between October 2017 and December 2020, patients undergoing pulmonary metastasectomy were recruited. Patients were assigned to undergo resection with either thoracotomy (group 1) or VATS (group 2) after multidisciplinary team discussions based on the number, size and location of pulmonary metastasis and underlying lung function. All related short-term surgical and pathologic outcomes for both groups were collected for analysis. Results: Of 58 patients enrolled, 21 were in group 1 and 37 in group 2. Colorectal cancer primary represented 40% of the cases. Patients in the VATS group were more likely to have solitary lesions that are peripherally located and removed by wedge resection, as opposed to patients in the thoracotomy group, who had more anatomical lung resections. More new nodules were likely to be detected during surgery in thoracotomy than VATS cases (p = 0. 027). However, 8 (out of 15) of the newly detected lesions were not malignant. Operative time, blood loss and hospital stay were in favor of VATS procedures. Conclusions: In a highly selected cohort of pulmonary metastasis patients with favorable criteria (peripherally located, small, solitary/oligo-metastasis and cN0), VATS may provide acceptable onco-pathologic outcomes as compared to the standard open thoracotomy.

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Section: Discussionmentioning

confidence: 99%

Role of video-assisted thoracoscopic surgery in pulmonary metastasectomy

Elkhayat¹,

Hamza²,

Elshoieby³

et al. 2022

kitp

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“…Conceptually, an ideal localizing technique would incorporate an agent specific to malignant lesions that can be given preoperatively without the need for invasive procedures. OTL-38 (On Target Laboratories, West Lafayette, IN) is a tissue-specific dye that binds a folate receptor that has been found to be highly expressed in greater than 80% of pulmonary adenocarcinomas [ 26 ]. Exposure to near-infrared light causes fluorescence.…”

Section: Reviewmentioning

confidence: 99%

State of the Art in Lung Nodule Localization

Alicuben

Lévesque

Ashraf

et al. 2022

JCM

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Lung nodule and ground-glass opacity localization for diagnostic and therapeutic purposes is often a challenge for thoracic surgeons. While there are several adjuncts and techniques in the surgeon’s armamentarium that can be helpful, accurate localization persists as a problem without a perfect solution. The last several decades have seen tremendous improvement in our ability to perform major operations with minimally invasive procedures and resulting lower morbidity. However, technological advances have not been as widely realized for lung nodule localization to complement minimally invasive surgery. This review describes the latest advances in lung nodule localization technology while also demonstrating that more efforts in this area are needed.

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