Learning curve of CT-guided localization with medical glue for single pulmonary nodule before video-assisted thoracic surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

TAN Xiaogang ¹ , ZHANG Qiuhang ² , LI Yan ³ , TIAN Xiaoru ¹ ,  LIU Baodong ¹

1. Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, P. R. China;
2. Department of Radiotherapy, Xuanwu Hospital, Capital Medical University, Beijing, 100053, P. R. China;
3. Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, P. R. China;

Corresponding author：

LIU Baodong, Email: xwliubaodong@aliyun.com

Keywords：

Pulmonary nodule; medical glue; localization; video-assisted thoracic surgery; learning curve

DOI：

10.7507/1007-4848.202201002

Video：

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Objective To evaluate the learning curve of CT-guided medical glue localization for pulmonary nodule before video-assisted thoracic surgery (VATS). Methods The clinical data of the patients with pulmonary nodules who underwent CT-guided medical glue localization before VATS in our hospital from July 2018 to March 2021 were retrospectively analyzed. The patients were divided into 3 groups: a group A (from July 2018 to August 2019), a group B (from September 2019 to June 2020) and a group C (from July 2020 to March 2021). The localization time, morbidity, complete resection rate and other indexes were compared among the three groups. Results A total of 77 patients were enrolled, including 24 males and 53 females aged 57.4±10.1 years. There were 25 patients in the group A, 21 patients in the group B, and 31 patients in the group C. 77 pulmonary nodules were localized. There was no significant difference among the groups in the basic data (P＞0.05). The localization time in the group C was 10.6±2.0 min, which was statistically shorter than that in the group A (15.4±4.4 min) and group B (12.9±4.3 min) (P＜0.01). The incidence of complications in the group C was lower than that in the group A and group B (25.8% vs. 52.0% vs. 47.6%, P=0.04). The success rate of localization of the three groups was not statistically different (P=0.12). Conclusion There is a learning curve in CT-guided medical glue localization for single pulmonary nodule before VATS. After the first 46 cases, the operation time can be shortened, and the incidence of complications can be decreased.

Citation： TAN Xiaogang, ZHANG Qiuhang, LI Yan, TIAN Xiaoru, LIU Baodong. Learning curve of CT-guided localization with medical glue for single pulmonary nodule before video-assisted thoracic surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(9): 1273-1279. doi: 10.7507/1007-4848.202201002 Copy

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7.	Miyoshi T, Aokage K, Katsumata S, et al. Ground-glass opacity is a strong prognosticator for pathologic stage ⅠA lung adenocarcinoma. Ann Thorac Surg, 2019, 108(1): 249-255.
8.	Awais O, Reidy MR, Mehta K, et al. Electromagnetic navigation bronchoscopy-guided dye marking for thoracoscopic resection of pulmonary nodules. Ann Thorac Surg, 2016, 102(1): 223-229.
9.	Deng C, Cao X, Wu D, et al. Small lung lesions invisible under fluoroscopy are located accurately by three-dimensional localization technique on chest wall surface and performed bronchoscopy procedures to increase diagnostic yields. BMC Pulm Med, 2016, 16(1): 166.
10.	Suzuki K, Nagai K, Yoshida J, et al. Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: Indications for preoperative marking. Chest, 1999, 115(2): 563-568.
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14.	谭晓刚, 刘宝东, 张毅. CT引导下医用胶在胸腔镜术前单侧多个或单一肺结节定位的应用. 中国肺癌杂志, 2022, 25(1): 1-6.
15.	刘宝东, 支修益, 刘磊, 等. CT引导下射频消融治疗中晚期非小细胞肺癌的近期疗效观察. 中国肺癌杂志, 2009, 12(7): 775-779.
16.	Travis WD, Brambilla E, Burke AP, et al. Introduction to the 2015 World Health Organization classification of tumors of the lung, pleura, thymus, and heart. J Thorac Oncol, 2015, 10(9): 1240-1242.
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20.	Huang BY, Zhou JJ, Song XY, et al. Clinical analysis of percutaneous computed tomography-guided injection of cyanoacrylate for localization of 115 small pulmonary lesions in 113 asymptomatic patients. J Int Med Res, 2019, 47(5): 2145-2156.
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22.	匡必婧, 张静, 牛玲莉, 等. 单孔胸腔镜技术的临床应用及学习曲线. 中国胸心血管外科临床杂志, 2021, 28(7): 826-829.
23.	Moore MJ, Bennett CL. The learning curve for laparoscopic cholecystectomy. The Southern Surgeons Club. Am J Surg, 1995, 170(1): 55-59.
24.	Yao F, Yao J, Xu L, et al. Computed tomography-guided cyanoacrylate localization of small pulmonary nodules: Feasibility and initial experience. Interact Cardiovasc Thorac Surg, 2019, 28(3): 387-393.
25.	Yan TD, King J, Sjarif A, et al. Learning curve for percutaneous radiofrequency ablation of pulmonary metastases from colorectal carcinoma: A prospective study of 70 consecutive cases. Ann Surg Oncol, 2006, 13(12): 1588-1595.
26.	刘宝东, 刘磊, 李岩, 等. CT引导下射频消融治疗肺癌的学习曲线. 中国微创外科杂志, 2012, 12(2): 160-163.
27.	肺小结节术前辅助定位技术专家共识(2019版)专家组. 肺小结节术前辅助定位技术专家共识(2019版). 中国胸心血管外科临床杂志, 2019, 26(2): 109-113.
28.	Scott WJ, Howington J, Feigenberg S, et al. Treatment of non-small cell lung cancer stage Ⅰ and stage Ⅱ: ACCP evidence-based clinical practice guidelines (2nd edition). Chest, 2007, 132(3 Suppl): 234S-242S.

1. Xiang D, Zhang B, Doll D, et al. Lung cancer screening: From imaging to biomarker. Biomark Res, 2013, 1(1): 4.
2. Hansell DM, Bankier AA, MacMahon H, et al. Fleischner Society: Glossary of terms for thoracic imaging. Radiology, 2008, 246(3): 697-722.
3. Henschke CI, Yankelevitz DF, Mirtcheva R, et al. CT screening for lung cancer: Frequency and significance of part-solid and nonsolid nodules. AJR Am J Roentgenol, 2002, 178(5): 1053-1057.
4. Tang EK, Chen CS, Wu CC, et al. Natural history of persistent pulmonary subsolid nodules: Long-term observation of different interval growth. Heart Lung Circ, 2019, 28(11): 1747-1754.
5. Kakinuma R, Noguchi M, Ashizawa K, et al. Natural history of pulmonary subsolid nodules: A prospective multicenter study. J Thorac Oncol, 2016, 11(7): 1012-1028.
6. Oh JY, Kwon SY, Yoon HI, et al. Clinical significance of a solitary ground-glass opacity (GGO) lesion of the lung detected by chest CT. Lung Cancer, 2007, 55(1): 67-73.
7. Miyoshi T, Aokage K, Katsumata S, et al. Ground-glass opacity is a strong prognosticator for pathologic stage ⅠA lung adenocarcinoma. Ann Thorac Surg, 2019, 108(1): 249-255.
8. Awais O, Reidy MR, Mehta K, et al. Electromagnetic navigation bronchoscopy-guided dye marking for thoracoscopic resection of pulmonary nodules. Ann Thorac Surg, 2016, 102(1): 223-229.
9. Deng C, Cao X, Wu D, et al. Small lung lesions invisible under fluoroscopy are located accurately by three-dimensional localization technique on chest wall surface and performed bronchoscopy procedures to increase diagnostic yields. BMC Pulm Med, 2016, 16(1): 166.
10. Suzuki K, Nagai K, Yoshida J, et al. Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: Indications for preoperative marking. Chest, 1999, 115(2): 563-568.
11. Chan EY, Gaur P, Ge Y, et al. Management of the solitary pulmonary nodule. Arch Pathol Lab Med, 2017, 141(7): 927-931.
12. Liu B, Gu C. Expert consensus workshop report: Guidelines for preoperative assisted localization of small pulmonary nodules. J Cancer Res Ther, 2020, 16(5): 967-973.
13. 周建华, 李文涛, 陈海泉, 等. 孤立性肺小结节在CT引导下带钩钢丝术前定位. 中华胸心血管外科杂志, 2011, 27(5): 316.
14. 谭晓刚, 刘宝东, 张毅. CT引导下医用胶在胸腔镜术前单侧多个或单一肺结节定位的应用. 中国肺癌杂志, 2022, 25(1): 1-6.
15. 刘宝东, 支修益, 刘磊, 等. CT引导下射频消融治疗中晚期非小细胞肺癌的近期疗效观察. 中国肺癌杂志, 2009, 12(7): 775-779.
16. Travis WD, Brambilla E, Burke AP, et al. Introduction to the 2015 World Health Organization classification of tumors of the lung, pleura, thymus, and heart. J Thorac Oncol, 2015, 10(9): 1240-1242.
17. Shrager JB. Approach to the patient with multiple lung nodules. Thorac Surg Clin, 2013, 23(2): 257-266.
18. Han L, Gao S, Tan F, et al. Experience and progress processing policy of simultaneous multiple primary lung cancer. Zhongguo Fei Ai Za Zhi, 2018, 21(3): 180-184.
19. Jiang G, Chen C, Zhu Y, et al. Shanghai Pulmonary Hospital experts consensus on the management of ground-glass nodules suspected as lung adenocarcinoma (version 1). Zhongguo Fei Ai Za Zhi, 2018, 21(3): 147-159.
20. Huang BY, Zhou JJ, Song XY, et al. Clinical analysis of percutaneous computed tomography-guided injection of cyanoacrylate for localization of 115 small pulmonary lesions in 113 asymptomatic patients. J Int Med Res, 2019, 47(5): 2145-2156.
21. Nakashima S, Watanabe A, Obama T, et al. Need for preoperative computed tomography-guided localization in video-assisted thoracoscopic surgery pulmonary resections of metastatic pulmonary nodules. Ann Thorac Surg, 2010, 89(1): 212-218.
22. 匡必婧, 张静, 牛玲莉, 等. 单孔胸腔镜技术的临床应用及学习曲线. 中国胸心血管外科临床杂志, 2021, 28(7): 826-829.
23. Moore MJ, Bennett CL. The learning curve for laparoscopic cholecystectomy. The Southern Surgeons Club. Am J Surg, 1995, 170(1): 55-59.
24. Yao F, Yao J, Xu L, et al. Computed tomography-guided cyanoacrylate localization of small pulmonary nodules: Feasibility and initial experience. Interact Cardiovasc Thorac Surg, 2019, 28(3): 387-393.
25. Yan TD, King J, Sjarif A, et al. Learning curve for percutaneous radiofrequency ablation of pulmonary metastases from colorectal carcinoma: A prospective study of 70 consecutive cases. Ann Surg Oncol, 2006, 13(12): 1588-1595.
26. 刘宝东, 刘磊, 李岩, 等. CT引导下射频消融治疗肺癌的学习曲线. 中国微创外科杂志, 2012, 12(2): 160-163.
27. 肺小结节术前辅助定位技术专家共识(2019版)专家组. 肺小结节术前辅助定位技术专家共识(2019版). 中国胸心血管外科临床杂志, 2019, 26(2): 109-113.
28. Scott WJ, Howington J, Feigenberg S, et al. Treatment of non-small cell lung cancer stage Ⅰ and stage Ⅱ: ACCP evidence-based clinical practice guidelines (2nd edition). Chest, 2007, 132(3 Suppl): 234S-242S.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Learning curve of CT-guided localization with medical glue for single pulmonary nodule before video-assisted thoracic surgery

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