Application of Simultaneous Localization of Multiple Pulmonary Nodules in a Hybrid Operating Room for Uniportal Video-Assisted Thoracic Surgery

Abstract

Qi Zhang,1 Zhiqiang Wang,1 Ying Liu,2 Huajie Xing,1 Jian Xu,1 Wei Xu,1 Huarong Cai,1 Yuequan Jiang1 1Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, People’s Republic of China; 2Youyang Tujia and Miao Autonomous County Center for Disease Control and Prevention, Chongqing, People’s Republic of ChinaCorrespondence: Yuequan Jiang Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, No. 181 of Hanyu Road, Shapingba District, Chongqing, 400030, People’s Republic of China Tel [phone] Fax [phone] Email [email protected]: This study explores the value of the application of simultaneous localization of multiple pulmonary nodules in a hybrid operating room for uniportal video-assisted thoracic surgery (VATS).Methods: This study performed a retrospective analysis of 60 patients with multiple pulmonary nodules (the number of nodules in every patient was ≥ 2, 131 in total) admitted to our hospital from September 2020 to September 2021. After computerized tomography (CT) scanning in a hybrid operating room, a multi-hook locating needle was used for simultaneous localization. The localization success, surgical resection, and locating needle unhooking rates of multiple pulmonary nodules were analyzed. The complication incidence, localization time, operation time, anesthesia time, post-isolation nodule search time, and postoperative hospital stay length were analyzed. In addition, the patients’ anxieties about the puncture localization were evaluated.Results: The intraoperative CT scans successfully showed all pulmonary nodules. The localization success, unhooking, and nodule resection rates were 98.5% (129/131), 1.5% (2/131), and 100% (131/131), respectively. The median times of the localization, operation, anesthesia, post-isolation pulmonary nodule search, and hospital stay were 19 min [interquartile range (IQR): 15– 30 min], 98 min (IQR: 80– 110 min), 149.5 min (IQR: 126– 171 min), 3.5 min (IQR: 1– 5 min), and 6 d (IQR: 4– 9 d), respectively. The incidences of pneumothorax and pulmonary hemorrhage were 20.0% (12/60) and 13.3% (8/60), respectively. The self-rating anxiety scale score of the patients was 53.6 ± 6.1.Conclusion: The hybrid operating room could be beneficial in accurately localizing multiple pulmonary nodules with reasonable safety and patient tolerance, and it is applicable to uniportal VATS.Keywords: hybrid operating room, intraoperative CT, multiple pulmonary nodules, uniportal thoracoscopy

Keywords

• hybrid operating room
• intraoperative ct
• multiple pulmonary nodules
• uniportal thoracoscopy