Feasibility of electromagnetic navigation bronchoscopy-guided lung resection for pulmonary ground-glass opacity nodules

Fluorescence-guided lung nodule identification during minimally invasive lung resections

In the last few years, minimally invasive surgery has become the standard routine practice to manage lung nodules. Particularly in the case of robotic thoracic surgery, the identification of the lung nodules that do not surface on the visceral pleura could be challenging. Therefore, together with the evolution of surgical instruments to provide the best option in terms of invasiveness, lung nodule localization techniques should be improved to achieve the best outcomes in terms of safety and sensibility. In this review, we aim to overview all principal techniques used to detect the lung nodules that do not present the visceral pleura retraction. We investigate the accuracy of fluorescence guided thoracic surgery in nodule detection and the differences among the most common tracers used.

COVID Tarnish Lung: Residual Radiological Lung Consequences of Infection with COVID-19

Background:

COVID-19 has still expressed as a mysterious viral infection with dramatic pulmonary consequences.

Objectives:

This article aims to study the radiological pulmonary consequences of respiratory covid-19 infection at 6 months and their relevance to the clinical stage, laboratory markers, and management modalities.

Patients and methods:

This study was implemented on two hundred and fifty (250) confirmed positive cases for COVID-19 infections. One hundred and ninety-seven cases (197) who completed the study displayed residual radiological lung shadowing (RRLS) on follow-up computed tomography (CT) of the chest. They were categorized by Simple clinical classification of COVID-19 into groups A, B and C.

Results:

GGO as well as reticulations were statistically significantly higher in group A than other two groups; however, bronchiectasis changes, parenchymal scarring, nodules as well as pleural tractions were statistically significantly higher in group C than the other two groups.

Conclusion:

Respiratory covid-19 infection might be linked to residual radiological lung shadowing. Ground glass opacities GGO, reticulations pervaded in mild involvement with lower inflammatory markers level, unlike, severe changes that expressed scarring, nodules and bronchiectasis changes accompanied by increased levels of inflammatory markers.

A novel localization technique for peripheral ground glass opacity using geometric parameters measured on CT images

Background

Currently no optimal localization technique has been established for localization of ground glass opacity (GGO). We aimed to introduce a localization technique using geometric localization for peripheral GGO.

Methods

We delineated the location of pulmonary GGO using geometric method which was similar with localization of a point in a spatial coordinate system. The localization technique was based on the anatomical landmarkers (ribs or intercostal spaces, capitulum costae and sternocostal joints). The geometric parameters were measured on preoperative CT images and the targeted GGO could be identified intraoperatively according to the parameters. We retrospectively collected the data of the patients with peripheral GGOs which were localized using this method and were wedge resected between June 2019 and July 2020. The efficacy and feasibility of the localization technique were assessed.

Results

There were 93 patients (male 34, median = 55 years) with 108 peripheral GGOs in the study. All the targeted GGOs were successfully wedge resected in the operative field with negative surgical margin at the first attempt. For each GGO, the localization parameters could be measured in 2–4 min (median = 3 min) on CT images before operation, and surgical resection could be completed in 5–10 min (median = 7 min). A total of 106 (98.15%) GGOs achieved sufficient resection margin. No complications and deaths occurred related to the localization and surgical procedure.

Conclusions

The localization technique can achieve satisfactory localization success rate and good safety profile. It can provide an easy-to-use alternative to localize peripheral GGO.