Thoracic Surgery, Video-Assisted
Conditions
Keywords
Preoperative localization, Stereoscopic Localization, Wedge Resection, Ground Glass Opacity
Brief summary
This study evaluates the feasibility，accuracy and safety of Preoperative Stereoscopic Localization Versus Methylene Blue Localization in GGO Wedge Resection. In the first stage，participants will receive both Preoperative Stereoscopic Localization and Methylene Blue Localization .In the second stage,participants only receive Preoperative Stereoscopic Localization for Wedge Resection.
Detailed description
More and more Ground Glass Opacity（GGO）are detected because of the early screening.According to Fleischner Society, for some solid GGO, surgical resection should be performed if the solid component is larger than 5mm.With the development of video-assisted thoracoscopic surgery (VATS) techniques, minimally invasive thoracic surgery has evolved considerably over the last three decades.However, localizing the small sized pulmonary nodules during VATS is challenging when there is no change in visceral pleura. Several traditional techniques have been described to localize peripheral pulmonary nodules, including preoperative CT-guided tattooing with methylene blue, CT scan guided spiral/hook wire placement and marking with radio-opaque materials. The traditional marking method have its strong and weak points. For the strong point, It provide a credible and precise nodule location to the surgeon. For the weak points:(1)a potential risk of pneumothorax and hemothorax.(2)Methylene blue have a tendency to diffuse over a large area during surgical preparation until the nodule's location is confirmed.(3)The Preoperative localization technique would need more time for the Preoperative preparation, which would be reduce the transport's efficiency.(4)It would occupy the resource of CT's usage.(5)Some of the methods ,such as methylene blue, maybe interference with the Pathological diagnosis.(6)These methods are all invasive operation, would Cause the patients' psychological fear. In order to avoid these weak points，the investigators use a new localization technique which has three basic steps: 1.Confirm the nodule's location in pulmonary segments. 2.Measure the distance between the nodule and anatomic landmarks on CT. 3. Estimate the changes of the distance between the nodule and anatomic landmarks after the alveolar atelectasis. The investigators have already succeed in some case.But,the further study is needed.Hence,the investigators designed a prospective study of Preoperative Stereoscopic Localization Versus Methylene Blue Localization in GGO Wedge Resection.Then,the investigators evaluate the feasibility，accuracy and safety of Preoperative Stereoscopic Localization Versus Methylene Blue Localization in GGO Wedge Resection.
Interventions
PROCEDUREPreoperative Stereoscopic Localization
1.Confirm the nodule's location and measure the distance between the nodule and anatomic landmarks from the CT scan. 2.According to the results of the first step，confirm the needle puncture site of the chest wall. 3.After general anesthesia and Patient positioning are completed, the needle is then inserted via the needle puncture site .
Sponsors
Guangdong Provincial People's Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Masking description
Eventhough only one group of participants，different investigators perform two kinds of localization techniques.
Intervention model description
Single group self-control study
Eligibility
Sex/Gender
ALL
Age
16 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Preoperative radiology revealed the solid component of GGO is larger than 5mm 2. Preoperative radiology revealed peripheral pulmonary nodule, with both size and depth less than 3 cm 3. Preoperative radiology revealed the distance from the lesion to the visceral pleura is larger than 5 mm
Exclusion criteria
1. Preoperative radiology revealed pneumonia or atelectasis 2. Any unstable systemic disease (including active infection, uncontrolled hypertension, unstable angina, congestive heart failure, myocardial infarction within the previous year, serious cardiac arrhythmia requiring medication, hepatic, renal, or metabolic disease). 3. Bleeding tendency or anticoagulant use 4. Pregnancy or breast feeding 5. Patient who can not sign permit
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| success rate of Stereoscopic Localization | 3 day | Success localization means that the distance from lession to anchor point is less than 3.0 cm. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Distance from A to B | 3 day | A:lession B：methylene blue anchor point To evaluate the accuracy of methylene blue localization.Measure the distance from lession to the methylene blue localization anchor point |
| Distance from A to C | 3 day | A:lession C：Stereoscopic Localization anchor point To evaluate the accuracy of Stereoscopic Localization localization.Measure the distance from lession to the Stereoscopic Localization localization anchor point |
| Comparison between Stereoscopic Localization success rate and Methylene Blue Localization success rate | 3 day | To evaluate the two kinds of Localization.Success localization means that the distance from lession to anchor point is less than 3.0 cm. |
| The success rate of wedge resection | 3 day | To evaluate the accuracy rate of localization |
| Postoperative adverse event incidence rate | 1 months | To evaluate the incidence rate of pneumothorax or perilesional hemorrhage in participants |
| Distance from B to C | 3 day | B：methylene blue anchor point C：Stereoscopic Localization anchor point To evaluate the two kinds of Localization.Measure the distance from methylene blue localization anchor point to the stereoscopic localization anchor point . |
Contacts
Primary ContactWen-Zhao Zhong, Ph.D
Outcome results
None listed