Percutaneous Lung Ablation Combined with Video-Assisted Thoracic Surgery Guided by Three-Dimensional Reconstruction in the Treatment of Multiple Pulmonary Nodules
DOI:
https://doi.org/10.30683/1927-7229.2025.14.03Keywords:
Multiple pulmonary nodules, lung microwave ablation, video-assisted thoracic surgeryAbstract
Background: With the wide application of lung cancer screening, the detection rate of multiple pulmonary nodules (MPNs) has increased annually. However, the optimal therapeutic strategy for MPNs has not achieved a consensus. This study aims to report a novel hybrid technique for the treatment of MPNs.
Methods: A total of 8 patients received CT-guided lung microwave ablation combined with video-assisted thoracic surgery from March 2020 to March 2023. Three-dimensional reconstruction was conducted to distinguish the precise localization, predict the resection extent, and conduct the optimal operation procedure for each lung nodule. The clinicopathological characteristics as well as surgical complications and short-term outcomes were recorded.
Results: 8 patients with a total of 18 nodules were treated by our hybrid technique. Two patients had a FEV1％ Pred lower than 90％. The nodules treated by surgery were confirmed as malignant by pathological results with a median size of 9mm.The median size of the nodules treated by ablation was 6mm. The median ablation power used for the nodules was 45 W (range, 40–50W). The ablation time was 5min. The median distance between nodules to pleura was 31mm (range 19-56mm). This hybrid technique did not increase the rate of complication and prolonged hospital stay. During the short term of follow-up, no recurrence occurred in the patients.
Conclusions: We present our experience of percutaneous lung ablation combined with video-assisted thoracic surgery guided by three-dimensional reconstruction in the treatment of multiple pulmonary nodules. This technique provides a minimally invasive and personalized therapy for patients with MPNs.
References
Balata H, Traverse-Healy L, Blandin-Knight S, et al. Attending community-based lung cancer screening influences smoking behaviour in deprived populations. Lung Cancer 2020; 139: 41-6.
Kim TJ, Goo JM, Lee KW, et al. Clinical, pathological and thin-section CT features of persistent multiple ground-glass opacity nodules: comparison with solitary ground-glass opacity nodule. Lung Cancer 2009; 64(2): 171-8.
Shimada Y, Saji H, Otani K, et al. Survival of a surgical series of lung cancer patients with synchronous multiple ground-glass opacities, and the management of their residual lesions. Lung Cancer 2015; 88(2): 174-80.
Alzubaidi SJ, Liou H, Saini G, et al. Percutaneous Image-Guided Ablation of Lung Tumors. J Clin Med 2021; 10(24).
Shang Y, Li G, Zhang B, et al. Image-guided percutaneous ablation for lung malignancies. Front Oncol 2022; 12: 1020296.
Chamarthy MR, Gupta M, Hughes TW, et al. Image-guided percutaneous ablation of lung malignancies: A minimally invasive alternative for nonsurgical patients or unresectable tumors. J Bronchology Interv Pulmonol 2014; 21(1): 68-81.
Zhang M, Mao N, Zhang K, et al. Analysis of the variation pattern in left upper division veins and establishment of simplified vein models for anatomical segmentectomy. Ann Transl Med 2020; 8(22): 1515.
Chen TF, Xie CY, Rao BY, et al. Surgical treatment to multiple primary lung cancer patients: a systematic review and meta-analysis. BMC Surg 2019; 19(1): 185.
Altorki N, Wang X, Kozono D, et al. Lobar or Sublobar Resection for Peripheral Stage IA Non-Small-Cell Lung Cancer. N Engl J Med 2023; 388(6): 489-98.
Yang H, Xiao X, Mei T, et al. Long-term survival analysis of sublobar resection versus lobectomy for older patients with early-stage pulmonary carcinoid tumour: a database-based propensity score-matched study. Aging Clin Exp Res 2022; 34(8): 1925-34.
Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet 2022; 399(10335): 1607-17.
Naidich DP, Bankier AA, MacMahon H, et al. Recommendations for the management of subsolid pulmonary nodules detected at CT: a statement from the Fleischner Society. Radiology 2013; 266(1): 304-17.
Wang XH, Liu XF, Ao M, et al. Cerebral Perfusion Patterns of Anxiety State in Patients With Pulmonary Nodules: A Study of Cerebral Blood Flow Based on Arterial Spin Labeling. Front Neurosci 2022; 16: 912665.
Qiu H, Lou Y, Wang Z, Xue F, Chen Z, Xu C, et al. Factors influencing surgical choice and anxiety in patients with pulmonary nodules smaller than 8 mm. Journal of Thoracic Disease 2023; 15(12): 6889-97.
Maxwell CM, Ng C, Fernando HC. Stereotactic Body Radiation Therapy Versus Ablation Versus Surgery for Early-Stage Lung Cancer in High-Risk Patients. Thorac Surg Clin 2023; 33(2): 179-87.
Huang BY, Li XM, Song XY, et al. Long-term results of CT-guided percutaneous radiofrequency ablation of inoperable patients with stage Ia non-small cell lung cancer: A retrospective cohort study. Int J Surg 2018; 53: 143-50.
Han X, Wei Z, Zhao Z, et al. Cost and effectiveness of microwave ablation versus video-assisted thoracoscopic surgical resection for ground-glass nodule lung adenocarcinoma. Front Oncol 2022; 12: 962630.
Harrison OJ, Sarvananthan S, Tamburrini A, et al. Image-guided combined ablation and resection in thoracic surgery for the treatment of multiple pulmonary metastases: A preliminary case series. JTCVS Tech 2021; 9: 156-62.
Qu R, Tu D, Hu S, et al. Electromagnetic Navigation Bronchoscopy-Guided Microwave Ablation Combined With Uniportal Video-Assisted Thoracoscopic Surgery for Multiple Ground Glass Opacities. Ann Thorac Surg 2022; 113(4): 1307-15.
Wang X, Wang Q, Zhang X, et al. Application of three-dimensional (3D) reconstruction in the treatment of video-assisted thoracoscopic complex segmentectomy of the lower lung lobe: A retrospective study. Front Surg 2022; 9: 968199.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Similar Articles
- Jianwen Lin, Jiali Yang, Jianjun Lu, Xiaoyi Hao, Jiawei Liu, Huali Yan, Huayi Li, Yu Guo, Yong Gu, Quanyong Cheng, Clinical Features of de Novo Lung Neuroendocrine Tumor after Liver Transplantation for Hepatocellular Carcinoma , Journal of Analytical Oncology: Vol. 11 (2022)
- Mervat Mahrous, Tasabeeh Mohamed, Ghassan Al SISI, Ahmed Al-Hujaily, Samira AlSumani, Primary Squamous Cell Carcinoma of the Breast is a Rare and Special Entity , Journal of Analytical Oncology: Vol. 7 No. 3 (2018)
- Sindhu Nagaraj, Rajesh Javarappa, V. Chendil, B.R. Kiran Kumar, Iqbal Ahmed, Amrut S. Kadam, Changes in Pulmonary Function and Development of Clinical Radiation Pneumonitis in Breast Cancer Patients following Post Mastectomy Radiation Therapy , Journal of Analytical Oncology: Vol. 9 (2020)
- Sajad Ahmad Salati, Amjaad Alkhezzi, Mohammad Ahmed Elmuttalut, Muhammad Munir Memon, Mushhood Memon, Multiple Primary Malignant Tumours , Journal of Analytical Oncology: Vol. 12 (2023)
- Mohamed Hegazi, Waleed El Nahas, Mohamed Elmetwally, Amr Hassan, Waleed Gado , Islam Abdou, Ahmed Senbel, Mohamed Samir Abou-Sheishaa, The Predictors of Multicentricity in Well-Differentiated Thyroid Cancer , Journal of Analytical Oncology: Vol. 7 No. 4 (2018)
- K. Namratha, Geeta S. Narayanan, S. Arpitha, K.R. Sindhu, B.R. Kiran Kumar, Dosimetric Analysis of Organs at Risk and its Correlation with Radiation Techniques in Left-Sided Breast Radiotherapy , Journal of Analytical Oncology: Vol. 14 (2025)
- H. Omer, O.Nasir, A. Suleiman, Evaluation of Single-Field Electron Beams for Postmastectomy Radiotherapy , Journal of Analytical Oncology: Vol. 1 No. 2 (2012)
- B. Raggiunti, A. Franchi, V. Congedo, S. Filipponi, G. Fiore, G. Raggiunti, D. Tina, A. Mongia, A. Rufo, F.A. Ruggieri , D. Di Michele , Mixed Medullary Papillary Thyroid Carcinoma in Hyperfunctioning Hot Nodule: A Case Report and Review of the Literature , Journal of Analytical Oncology: Vol. 3 No. 3 (2014)
- Toshihiro Kushibiki, Miya Ishihara, Photoacoustic Imaging for Cancer Diagnosis , Journal of Analytical Oncology: Vol. 2 No. 2 (2013)
- Abigail Ruiz de Lobera, Aitziber Buqué, Alberto Muñoz, Sergio Carrera, Aintzane Sancho, Itziar Rubio, Eddy I. Gutierrez, Mikel Arruti, Inés Marrodán, Guillermo López-Vivanco, Bevacizumab in Combination with FOLFIRI in the First-Line Treatment of Patients with Advanced Colorectal Cancer: A Single-Institution Experience , Journal of Analytical Oncology: Vol. 3 No. 1 (2014)
You may also start an advanced similarity search for this article.