Localization of ground-glass opacifications (GGOs) with more than 1cm distance to the pleura are still a challenge to thoracic surgeons during video-assisted thoracoscopic surgery (VATS). Efficiency, damage avoidance, and safety are uppermost factors to be considered when choosing the location technique. Our center tested the thoracoscopic ultrasound (US) as a complementary method during VATS GGOs surgery.
We evaluated 40 patients with GGOs divided into group A (VATS-US) and group B (VATS). We used positive pressure in the chest cavity during surgery in group A to decrease the time needed to collapse the lung. With the same excision standard between the two groups, we recorded and compared the time needed, ratio of converting to thoracotomy, blooding volume, and any complications observed.
We found that the use of ultrasound during VATS surgery could improve the success rate of localization (p < 0.05), especially in patients where it was difficult to conduct preoperative CT guided localization (p < 0.01). There were no statistically significant differences between the two groups in operation time, bleeding during the operation, or postoperative complications (p > 0.05).
We concluded that thoracoscopic ultrasound could be an excellent supplement to preoperative CT localizing technique for localization of GGOs, if not a replacement at present.
Clinical trial identification
Legal entity responsible for the study
Peking University International Hospital.
The author has declared no conflicts of interest.