Augmented fluoroscopic bronchoscopy (AFB) versus percutaneous computed tomography-guided dye localization for thoracosco
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and Other Interventional Techniques
Augmented fluoroscopic bronchoscopy (AFB) versus percutaneous computed tomography‑guided dye localization for thoracoscopic resection of small lung nodules: a propensity‑matched study Shun‑Mao Yang1,2 · Yi‑Chang Chen3 · Wei‑Chun Ko3 · Hsin‑Chieh Huang3 · Kai‑Lun Yu4 · Huan‑Jang Ko2 · Pei‑Ming Huang1,5 · Yeun‑Chung Chang3 Received: 28 August 2019 / Accepted: 24 December 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Dye localization is a useful method for the resection of unidentifiable small pulmonary lesions. This study compares the transbronchial route with augmented fluoroscopic bronchoscopy (AFB) and conventional transthoracic CTguided methods for preoperative dye localization in thoracoscopic surgery. Methods Between April 2015 and March 2019, a total of 231 patients with small pulmonary lesions who received preoperative dye localization via AFB or percutaneous CT-guided technique were enrolled in the study. A propensity-matched analysis, incorporating preoperative variables, was used to compare localization and surgical outcomes between the two groups. Results After matching, a total of 90 patients in the AFB group (N = 30) and CT-guided group (N = 60) were selected for analysis. No significant difference was noted in the demographic data between both the groups. Dye localization was successfully performed in 29 patients (96.7%) and 57 patients (95%) with AFB and CT-guided method, respectively. The localization duration (24.1 ± 8.3 vs. 21.4 ± 12.5 min, p = 0.297) and equivalent dose of radiation exposure (3.1 ± 1.5 vs. 2.5 ± 2.0 mSv, p = 0.130) were comparable in both the groups. No major procedure-related complications occurred in either group; however, a higher rate of pneumothorax (0 vs. 16.7%, p = 0.029) and focal intrapulmonary hemorrhage (3.3 vs. 26.7%, p = 0.008) was noted in the CT-guided group. Conclusion AFB dye marking is an effective alternative for the preoperative localization of small pulmonary lesions, with a lower risk of procedure-related complications than the conventional CT-guided method. Keywords Dye localization · Augmented fluoroscopy · CT-guided · Small lung nodules · Thoracoscopy
Shun-Mao Yang and Yi-Chang Chen have contributed equally to this work and are first co-authors. * Pei‑Ming Huang [email protected] 1
Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
2
Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
3
Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
4
Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
5
Department of Surgery, National Taiwan University Hospital, Yun-Lin Branch, Yunlin County, Taiwan
Lung cancer is the leading cause of cancer-related deaths in most countries [1]. Through the growing utilization
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