초록접수 현황
| 17F-279 | 구연 미채택시 포럼 발표 |
Factors Affecting Efficacy of Intraoperative Localization of Small Peripheral GGN with Electromagnatic Navigation Bronchoscopy
Kwanyong Hyun, In Kyu Park, Samina Park, Yoohwa Hwang, Hyun Joo Lee, Chang Hyun Kang, Young Tae Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Purpose : Electromagnetic navigational bronchoscopy (ENB)-guided dye marking is a novel method to localize peripheral GGNs. This method is being used with increasing frequency, which makes the accurate target planning important for effective navigation. We investigated factors affecting the efficacy of targeting
Methods : Patients with sub-centimeter GGN who underwent ENB-guided marking and VATS resection from July 2016 to August 2017 were reviewed retrospectively. Marking target was set at the nearest pleura from GGN. Data including location of the target, target-angle from navigation pathway, target-distance (from navigation tip to the target), and navigation-time were collected and analyzed.
Results : A total of 36 ENB-guided markings were performed in 26 patients. Dye-marker was not visible in 5 nodules (14%), but all 30 GGNs were completely resected. The location of targets were 9 in upper zone, 19 in middle zone, and 8 in lower zone. While the target-distance showed no significant inter-zone difference, the navigation-time was longer in the upper zone (upper vs middle/lower, 9.9±9.5 min vs 5.3±3.0 min, p=0.19). Target-angle did not affect navigation-time nor target-distance in regression analysis (p=0.24, p=0.18) Multiple linear regression analyses for the predictor of navigation-time with target-location, target-angle, and target-distance revealed that upper zone was a significant predictor (ß=4.8, t=2.5, p=0.02).
Conclusion : Target-location in the upper zone is related to increased navigation-time. However, targeting accuracy could be maintained constantly irrespective of target-zone. More experience of target setting and selection of catheter-angle are necessary to enhance the efficacy of ENB-guided dye marking.
Methods : Patients with sub-centimeter GGN who underwent ENB-guided marking and VATS resection from July 2016 to August 2017 were reviewed retrospectively. Marking target was set at the nearest pleura from GGN. Data including location of the target, target-angle from navigation pathway, target-distance (from navigation tip to the target), and navigation-time were collected and analyzed.
Results : A total of 36 ENB-guided markings were performed in 26 patients. Dye-marker was not visible in 5 nodules (14%), but all 30 GGNs were completely resected. The location of targets were 9 in upper zone, 19 in middle zone, and 8 in lower zone. While the target-distance showed no significant inter-zone difference, the navigation-time was longer in the upper zone (upper vs middle/lower, 9.9±9.5 min vs 5.3±3.0 min, p=0.19). Target-angle did not affect navigation-time nor target-distance in regression analysis (p=0.24, p=0.18) Multiple linear regression analyses for the predictor of navigation-time with target-location, target-angle, and target-distance revealed that upper zone was a significant predictor (ß=4.8, t=2.5, p=0.02).
Conclusion : Target-location in the upper zone is related to increased navigation-time. However, targeting accuracy could be maintained constantly irrespective of target-zone. More experience of target setting and selection of catheter-angle are necessary to enhance the efficacy of ENB-guided dye marking.
책임저자: In Kyu Park
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: Kwanyong Hyun, E-mail : pipedragon@gmail.com