Preoperative localization indication of clinical peripheral pulmonary ground-glass nodules by Da Vinci robot surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Xiapeng ¹ , XU Wei ² , DING Renquan ² , XU Shiguang ² , LIU Bo ² , WANG Xilong ² , WANG Tong ² , MENG Hao ² , WU Ziheng ² , YANG Zilin ² , CHAI Xinchun ² ,  WANG Shumin ²

1. Graduate Training Base of General Hospital of Northern Theater Command, Dalian Medical School, Shenyang, 110016, P.R.China;
2. Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P.R.China;

Corresponding author：

WANG Shumin, Email: sureman2003congo@163.com

Keywords：

Pulmonary ground-glass nodule; methylene blue; one-stop composite surgery; preoperative localization; Da Vinci surgical system

DOI：

10.7507/1007-4848.201911012

Video：

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Objective To investigate the preoperative localization of pulmonary glabrous nodules.Methods A total of 192 patients admitted to General Hospital of Northern Theater Command from April 2012 to September 2019 were selected for the study. There were 95 males and 97 females at an age of 56.47±11.79 years. All patients completed preoperative examination, and were divided into a positioning group (n=97) and a non-positioning group (n=95) according to whether the preoperative positioning was performed. And the surgical indicators between the two groups were compared. According to the substance of ground-glass opacity, they were divided into a pure ground-glass nodules group (n=23) and a mixed ground-glass nodules group (n=74) in the positioning group and a pure ground-glass nodules group (n=14) and a mixed ground-glass nodules group (n=81) in the non-positioning group . According to the size and distance of the nodules from the pleura and whether the nodules could be detected, the corresponding linear function was obtained.Results The operative time of methylene blue localization group was shorter than that of the no localization group. In the scatter plot, the corresponding diameter and depth of the nodules and the corresponding coordinate points which can be explored were described. And linear regression was performed on all the coordinate points to obtain the linear function: depth=0.648×diameter–1.446 (mm). It can be used as an indication for the preoperative localization of pure ground-glass nodules in Da Vinci robotic surgery. Linear function: depth=0.559 5×diameter+0.56 (mm). It can be used as an indication of preoperative localization of mixed ground-glass nodules in Da Vinci robotic surgery.Conclusion This equation can be used as a preoperative indication for clinical peripheral pulmonary ground-glass nodules.

Citation： LI Xiapeng, XU Wei, DING Renquan, XU Shiguang, LIU Bo, WANG Xilong, WANG Tong, MENG Hao, WU Ziheng, YANG Zilin, CHAI Xinchun, WANG Shumin. Preoperative localization indication of clinical peripheral pulmonary ground-glass nodules by Da Vinci robot surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(2): 173-177. doi: 10.7507/1007-4848.201911012 Copy

1.	邵兵, 郑晶晶, 李思阳. 达芬奇机器人联合西门子 Artis Zeego“一站式” Hybrid 手术在肺磨玻璃样病变术前定位中临床应用及效果. 创伤与急危重病医学, 2018, 6(1): 18-24.
2.	Saito H, Minamiya Y, Matsuzaki I, et al. Indication for reoperative localization of small peripheral pulmonary nodules in thoracoscopic surgery. J Thorac Cardiovasc Sur, 2002, 124(6): 1198-1202.
3.	何锋, 林铿强, 许德新. 医用 ZT 胶在肺部结节病灶胸腔镜术前定位的应用. 临床肺科杂志, 2014, 19(10): 1880-1882.
4.	Yun S, Kang H, Park S, et al. Diagnostic accuracy and complications of CT-guided core needle lung biopsy of solid and part-solid lesions. Br J Radiol, 2018, 91(1088): 20170946.
5.	Sakatani T, Amano Y, Sato J, et al. Air embolism after CT-guided percutaneous lung biopsy. Jpn J Clin Oncol, 2018, 48(7): 699-700.
6.	Monnin-Bares V, Chassagnon G, Vernhet-Kovacsik H, et al. Systemic air embolism depicted on systematic whole thoracic CT acquisition after percutaneous lung biopsy: Incidence and risk factors. Eur J Radiol, 2019, 117: 26-32.
7.	Su TH, Fan YF, Jin L, et al. CT-guided localization of small pulmonary nodules using adjacent microcoil implantation prior to video-assisted thoracoscopic surgical resection. Eur Radiol, 2015, 25(9): 2627-2633.
8.	Velasquez R, Martin A, Abu Hishmeh M, et al. Placement of markers to assist minimally invasive resection of peripheral lung lesions. Ann Transl Med, 2019, 7(15): 360.
9.	张瑞杰, 付向宁. 肺部磨玻璃结节单孔胸腔镜术前 CT 引导下贝朗胶联合亚甲蓝定位技术的应用. 中国内镜杂志, 2018, 24(11): 93-96.
10.	Sato M, Omasa M, Chen F, et al. Use of virtual assisted lung mapping (VAL-MAP), a bronchoscopic multispot dye-marking technique using virtual images, for precise navigation of thoracoscopic sublobar lung resection. J Thorac Cardiovasc Surg, 2014, 147(6): 1813-1819.
11.	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.
12.	Arias S, Lee H, Semaan R, et al. Use of electromagnetic navigational transthoracic needle aspiration (E-TTNA) for sampling of lung nodules. J Vis Exp, 2015, (99): e52723.
13.	van't Westeinde SC, de Koning HJ, Xu DM, et al. How to deal with incidentally detected pulmonary nodules less than 10mm in size on CT in a healthy person. Lung Cancer, 2008, 60(2): 151-159.
14.	单立群, 胡坚, 李明东, 等. 胸腔镜在肺部微小结节诊治中的应用. 中国肺癌杂志, 2013, 16(7): 369-372.
15.	Shan L, Hu J, Li M, et al. Applications of video-assisted thoracic surgery for the diagnosis and treatment of patients with small pulmonary nodules. Zhongguo Fei Ai Za Zhi, 2013, 16(7): 369-372.
16.	Migliore M, Fornito M, Palazzolo M, et al. Ground glass opacities management in the lung cancer screening era. Ann Transl Med, 2018, 6(5): 90.
17.	Siu ICH, Li Z, Ng CSH. Latest technology in minimally invasive thoracic surgery. Ann Transl Med, 2019, 7(2): 35.
18.	Zheng R, Devin CL, O'Malley T, et al. Surgical management of growing teratoma syndrome: robotic-assisted thoracoscopic resection of mediastinal teratoma. Surg Endosc, 2019. doi: 10.1007/s00464-019-07177-z. [Epub ahead of print].
19.	Ilonen IK, Räsänen JV, Knuuttila A, et al. Anatomic thoracoscopic lung resection for non-small cell lung cancer in stageⅠis associated with less morbidity and shorter hospitalization than thoracotomy. Acta Oncol, 2011, 50(7): 1126-1132.
20.	Odaka M, Noda Y, Tsukamoto Y, et al. Impact of the introduction of thoracoscopic lobectomy for non-small cell lung cancer: a propensity score-matched analysis. J Thorac Dis, 2018, 10(8): 4985-4993.
21.	Laursen LØ, Petersen RH, Hansen HJ, et al. Video-assisted thoracoscopic surgery lobectomy for lung cancer is associated with a lower 30-day morbidity compared with lobectomy by thoracotomy. Eur J Cardiothorac Surg, 2016, 49(3): 870-875.

1. 邵兵, 郑晶晶, 李思阳. 达芬奇机器人联合西门子 Artis Zeego“一站式” Hybrid 手术在肺磨玻璃样病变术前定位中临床应用及效果. 创伤与急危重病医学, 2018, 6(1): 18-24.
2. Saito H, Minamiya Y, Matsuzaki I, et al. Indication for reoperative localization of small peripheral pulmonary nodules in thoracoscopic surgery. J Thorac Cardiovasc Sur, 2002, 124(6): 1198-1202.
3. 何锋, 林铿强, 许德新. 医用 ZT 胶在肺部结节病灶胸腔镜术前定位的应用. 临床肺科杂志, 2014, 19(10): 1880-1882.
4. Yun S, Kang H, Park S, et al. Diagnostic accuracy and complications of CT-guided core needle lung biopsy of solid and part-solid lesions. Br J Radiol, 2018, 91(1088): 20170946.
5. Sakatani T, Amano Y, Sato J, et al. Air embolism after CT-guided percutaneous lung biopsy. Jpn J Clin Oncol, 2018, 48(7): 699-700.
6. Monnin-Bares V, Chassagnon G, Vernhet-Kovacsik H, et al. Systemic air embolism depicted on systematic whole thoracic CT acquisition after percutaneous lung biopsy: Incidence and risk factors. Eur J Radiol, 2019, 117: 26-32.
7. Su TH, Fan YF, Jin L, et al. CT-guided localization of small pulmonary nodules using adjacent microcoil implantation prior to video-assisted thoracoscopic surgical resection. Eur Radiol, 2015, 25(9): 2627-2633.
8. Velasquez R, Martin A, Abu Hishmeh M, et al. Placement of markers to assist minimally invasive resection of peripheral lung lesions. Ann Transl Med, 2019, 7(15): 360.
9. 张瑞杰, 付向宁. 肺部磨玻璃结节单孔胸腔镜术前 CT 引导下贝朗胶联合亚甲蓝定位技术的应用. 中国内镜杂志, 2018, 24(11): 93-96.
10. Sato M, Omasa M, Chen F, et al. Use of virtual assisted lung mapping (VAL-MAP), a bronchoscopic multispot dye-marking technique using virtual images, for precise navigation of thoracoscopic sublobar lung resection. J Thorac Cardiovasc Surg, 2014, 147(6): 1813-1819.
11. 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.
12. Arias S, Lee H, Semaan R, et al. Use of electromagnetic navigational transthoracic needle aspiration (E-TTNA) for sampling of lung nodules. J Vis Exp, 2015, (99): e52723.
13. van't Westeinde SC, de Koning HJ, Xu DM, et al. How to deal with incidentally detected pulmonary nodules less than 10mm in size on CT in a healthy person. Lung Cancer, 2008, 60(2): 151-159.
14. 单立群, 胡坚, 李明东, 等. 胸腔镜在肺部微小结节诊治中的应用. 中国肺癌杂志, 2013, 16(7): 369-372.
15. Shan L, Hu J, Li M, et al. Applications of video-assisted thoracic surgery for the diagnosis and treatment of patients with small pulmonary nodules. Zhongguo Fei Ai Za Zhi, 2013, 16(7): 369-372.
16. Migliore M, Fornito M, Palazzolo M, et al. Ground glass opacities management in the lung cancer screening era. Ann Transl Med, 2018, 6(5): 90.
17. Siu ICH, Li Z, Ng CSH. Latest technology in minimally invasive thoracic surgery. Ann Transl Med, 2019, 7(2): 35.
18. Zheng R, Devin CL, O'Malley T, et al. Surgical management of growing teratoma syndrome: robotic-assisted thoracoscopic resection of mediastinal teratoma. Surg Endosc, 2019. doi: 10.1007/s00464-019-07177-z. [Epub ahead of print].
19. Ilonen IK, Räsänen JV, Knuuttila A, et al. Anatomic thoracoscopic lung resection for non-small cell lung cancer in stageⅠis associated with less morbidity and shorter hospitalization than thoracotomy. Acta Oncol, 2011, 50(7): 1126-1132.
20. Odaka M, Noda Y, Tsukamoto Y, et al. Impact of the introduction of thoracoscopic lobectomy for non-small cell lung cancer: a propensity score-matched analysis. J Thorac Dis, 2018, 10(8): 4985-4993.
21. Laursen LØ, Petersen RH, Hansen HJ, et al. Video-assisted thoracoscopic surgery lobectomy for lung cancer is associated with a lower 30-day morbidity compared with lobectomy by thoracotomy. Eur J Cardiothorac Surg, 2016, 49(3): 870-875.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Preoperative localization indication of clinical peripheral pulmonary ground-glass nodules by Da Vinci robot surgery

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