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P. Hohenberger



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    P3.04 - Poster Session with Presenters Present (ID 474)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P3.04-008 - CATS: Computed Tomography-Assisted Thoracoscopic Surgery - A Novel Approach in Patients with Deep Intrapulmonary Lesions of Unknown Dignity (ID 5002)

      14:30 - 14:30  |  Author(s): P. Hohenberger

      • Abstract

      Background:
      National Lung Screening Trial using low-dose CT may result in a relative reduction in mortality from lung cancer. Screening programs to be implemented will result in more patients being diagnosed with unclear pulmonary lesions and indicate excisional biopsy. Minimal invasive resection of small, deep intrapulmonary lesions can be challenging as the lesions are difficult to localize during VATS surgery. We introduced an intraoperative cone-beam computed tomography (CBCT) system in a hybrid operating theatre to place a marking wire immediately prior to VATS removal of the suspected lesions.

      Methods:
      Fifteen patients (5 m, 10 f, median age 63yrs) with solitary, deep intrapulmonary nodules of unknown histological status were identified for intraoperative wire marking. While being under general anaesthesia for VATS, patients were placed on the operating table. and a marking wire was placed within the lesion under 3D laser and fluoroscopic guidance using the CBCT system (Artis zeego, Siemens Healthcare GmbH, Germany). Then wedge resection by VATS was performed in the same setting without any repositioning the patient.

      Results:
      Complete resection with adequate safety margins was confirmed for all lesions. Marking wire placement facilitated resection in 15 out of 16 lesions. Histologically, mean lesion size was 7.5mm. The mean distance of the lesion to the pleural surface was 15.9mm (mean lesion depth/lesion diameter ratio = 2.3). Eleven lesions proved to be malignant, either primary lung cancer or metastases from prior malignancies. Five lesions turned out to be benign. Mean procedural time for marking wire placement was 35min; mean VATS duration was 36min. There is a learning curve fo the whole team involving anesthesiology, radiology, and thoracic surgery.

      Conclusion:
      CATS is a new, safe, and effective procedure for minimally invasive resection of small, deeply localized intrapulmonary lesions. The benefits of CATS are: (1) 'one-stop shopping' procedure to locate and remove small lung lesions (2) lower risk for the patient (no patient relocation intraoperatively, no marking wire loss), and (3) no necessity to coordinate scheduling between CT and operating theatre.

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    SH02 - WCLC 2016 Scientific Highlights - SCLC, Mesothelioma and Thymic Malignancies (ID 484)

    • Event: WCLC 2016
    • Type: Scientific Highlights
    • Track: SCLC/Neuroendocrine Tumors
    • Presentations: 1
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      SH02.03 - Thymic Malignancies & Esophageal Cancer (ID 7122)

      08:10 - 08:30  |  Author(s): P. Hohenberger

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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