Application of Body Tom® mobile CT combined with basic anesthesia in preoperative painless localization of small pulmonary nodules: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YAO Mengxu ^1,2 , SUN Yungang ^1,2 , ZHANG Qiang ^1,2 ,  SHAO Feng ^1,2

1. Department of Thoracic Surgery, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, P. R. China;
2. Pulmonary Nodule Diagnosis and Treatment Research Center, Nanjing Medical University, Nanjing, 210029, P. R. China;

Corresponding author：

SHAO Feng, Email: doctorshao1982@sina.com

Keywords：

Pulmonary nodule; localization; mobile CT; basic anesthesia; retrospective cohort study

DOI：

10.7507/1007-4848.202212046

Video：

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Objective To explore the application of Body Tom® mobile CT combined with basic anesthesia in preoperative painless positioning of small pulmonary nodules, and evaluate its safety and effectiveness. Methods Patients using mobile Body Tom® CT to accurately locate pulmonary nodules in the Department of Thoracic Surgery of Affiliated Nanjing Brain Hospital, Nanjing Medical University from August to October 2022 were retrospectively included. Clinical data of the whole patient group were analyzed. Results We finally included 30 patients with 12 males and 18 females at age of 23-71 years. The position success rate of 30 patients with small pulmonary nodules was 100.0%. Location time was 14.20±4.07 min. There was one patient of intrapulmonary hemorrhage, with no other complications such as pneumothorax, positioning needle shedding, or pleural reaction. The time from the end of positioning to the start of surgery was 12.63±5.68 min. There was no needle migration or indocyanine green overflow. All patients completed resection of small pulmonary nodules under single-port thoracoscopy, no transit to opening chest. The average operation time was 85.32±12.60 min. There was no postoperative complications, and the average postoperative chest tube retention time was 2.12±1.34 days. And the average length of hospital stay was 3.52±1.45 days. The postoperative pathological results showed that the distance from the nodules was greater than 2 cm. Conclusion Body Tom® mobile CT combined with basic anesthesia can achieve the preoperative painless, precise positioning of pulmonary nodules, effectively reduce the incidence of preoperative positioning complications, shorten the operation waiting time, ensure the safety and effectiveness of patients with preoperative pulmonary nodules positioning, and further improve the surgical comfort of patients, which has certain clinical application value.

Citation： YAO Mengxu, SUN Yungang, ZHANG Qiang, SHAO Feng. Application of Body Tom® mobile CT combined with basic anesthesia in preoperative painless localization of small pulmonary nodules: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(9): 1267-1272. doi: 10.7507/1007-4848.202212046 Copy

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4.	程载兴, 梅培圆, 万黎, 等. 电磁导航定位与CT引导下经皮穿刺定位在肺结节手术中应用的系统评价与Meta分析. 中国胸心血管外科临床杂志, 2022, 29(1): 23-29.
5.	史立波, 张曼丽, 刘秀祥, 等. 右美托咪定基础麻醉联合局麻在Ⅰ期乳腺癌保乳手术中的应用. 医学与哲学(B), 2016, 37(2): 33-35.
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8.	Yang SM, Ko WC, Lin MW, et al. Image-guided thoracoscopic surgery with dye localization in a hybrid operating room. J Thorac Dis, 2016, 8(9): 681-689.
9.	Fujikawa R, Otsuki Y, Nakamura H, et al. Marking method for peripheral non-palpable pulmonary nodules using a mobile computed tomography scanner with a navigation system. Gen Thorac Cardiovasc Surg, 2020, 68(10): 1220-1223.
10.	Sun Y, Zhang Q, Wang Z, et al. Real-time image-guided indocyanine green fluorescence dual-visualization technique to measure the intraoperative resection margin during thoracoscopic segmentectomy. Asia Pac J Clin Oncol, 2023, 12(9): e39-e44.
11.	于修义, 耿国军, 刘鸿鸣, 等. 移动CT在肺小结节术前及术中定位中的价值. 中国微创外科杂志, 2019, 19(5): 418-420.
12.	张海清, 孙建新, 陈亚宽, 等. 咪达唑仑、枸橼酸舒芬太尼静脉基础麻醉应用于电子支气管镜检查中的临床效果研究. 中国实用医药, 2022, 17(5): 21-23.
13.	Yu H, Tian W, Sun Y, et al. Localization of small peripheral pulmonary nodules for surgical resection: A new intraoperative technique in hybrid operating room. J Cardiothorac Surg, 2022, 17(1): 241.
14.	刘庆文, 殷志敏, 王霄霖, 等. 三维重建联合Hookwire定位肺小结节在胸腔镜肺段切除术中的应用. 中国胸心血管外科临床杂志, 2020, 27(7): 802-806.
15.	Yang F, Zhao H, Sui X, et al. Comparative study on preoperative localization techniques using microcoil and hookwire by propensity score matching. Thorac Cancer, 2020, 11(6): 1386-1395.
16.	Li CD, Huang ZG, Sun HL, et al. CT-guided preoperative localization of ground glass nodule: Comparison between the application of embolization microcoil and the locating needle designed for pulmonary nodules. Br J Radiol, 2021, 94(1123): 20210193.

1. 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.
2. Chao YK, Fang HY, Wen YW, et al. Intraoperative computed tomography-guided pulmonary tumour localization: A thoracic surgeon's learning curve. Eur J Cardiothorac Surg, 2019, 55(3): 421-426.
3. Tian Y, An J, Zou Z, et al. Computed tomography-guided microcoil localization of pulmonary nodules: Effects of multiple punctures. Thorac Cardiovasc Surg, 2021, Epub ahead of print.
4. 程载兴, 梅培圆, 万黎, 等. 电磁导航定位与CT引导下经皮穿刺定位在肺结节手术中应用的系统评价与Meta分析. 中国胸心血管外科临床杂志, 2022, 29(1): 23-29.
5. 史立波, 张曼丽, 刘秀祥, 等. 右美托咪定基础麻醉联合局麻在Ⅰ期乳腺癌保乳手术中的应用. 医学与哲学(B), 2016, 37(2): 33-35.
6. Hsieh MJ, Chou PL, Fang HY, et al. Single-step localization and excision of small pulmonary nodules using a mobile 3D C-arm. Interact CardioVasc Thorac Surg, 2022, 34(3): 513.
7. Uebayashi A, Fujikawa R, Arai Y, et al. Preoperative marking of a submillimeter metastatic pulmonary tumor using a mobile computed tomography scan with a navigation system: A case report. Int J Surg Case Rep, 2021, 79: 350-353.
8. Yang SM, Ko WC, Lin MW, et al. Image-guided thoracoscopic surgery with dye localization in a hybrid operating room. J Thorac Dis, 2016, 8(9): 681-689.
9. Fujikawa R, Otsuki Y, Nakamura H, et al. Marking method for peripheral non-palpable pulmonary nodules using a mobile computed tomography scanner with a navigation system. Gen Thorac Cardiovasc Surg, 2020, 68(10): 1220-1223.
10. Sun Y, Zhang Q, Wang Z, et al. Real-time image-guided indocyanine green fluorescence dual-visualization technique to measure the intraoperative resection margin during thoracoscopic segmentectomy. Asia Pac J Clin Oncol, 2023, 12(9): e39-e44.
11. 于修义, 耿国军, 刘鸿鸣, 等. 移动CT在肺小结节术前及术中定位中的价值. 中国微创外科杂志, 2019, 19(5): 418-420.
12. 张海清, 孙建新, 陈亚宽, 等. 咪达唑仑、枸橼酸舒芬太尼静脉基础麻醉应用于电子支气管镜检查中的临床效果研究. 中国实用医药, 2022, 17(5): 21-23.
13. Yu H, Tian W, Sun Y, et al. Localization of small peripheral pulmonary nodules for surgical resection: A new intraoperative technique in hybrid operating room. J Cardiothorac Surg, 2022, 17(1): 241.
14. 刘庆文, 殷志敏, 王霄霖, 等. 三维重建联合Hookwire定位肺小结节在胸腔镜肺段切除术中的应用. 中国胸心血管外科临床杂志, 2020, 27(7): 802-806.
15. Yang F, Zhao H, Sui X, et al. Comparative study on preoperative localization techniques using microcoil and hookwire by propensity score matching. Thorac Cancer, 2020, 11(6): 1386-1395.
16. Li CD, Huang ZG, Sun HL, et al. CT-guided preoperative localization of ground glass nodule: Comparison between the application of embolization microcoil and the locating needle designed for pulmonary nodules. Br J Radiol, 2021, 94(1123): 20210193.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of Body Tom® mobile CT combined with basic anesthesia in preoperative painless localization of small pulmonary nodules: A retrospective cohort study

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