Microwave ablation of lung nodules produces faster and larger ablation zones than other energy sources, while bronchoscopic route of access may avoid pleural-based complications associated with traditional percutaneous access. The combination of both is a novel approach in management of suspicious or malignant lung nodules.
Lung nodule microwave ablation was performed in hybrid operating room under electromagnetic navigation bronchoscopy guidance. Our center's experience between March 2019 and December 2020 was retrospectively analyzed. Patients had high surgical risks while lung nodules were either proven malignant or radiologically suspicious. Technical feasibility and safety were primarily evaluated.
Total of 44 lung nodules from 36 patients were treated. Mean nodule size was 15.2 mm. Technical success rate was 100%, although some nodules required double ablation for adequate coverage. Mean minimal ablation margin was 5.79 mm. The mean actual ablation zone volume was -20.9% compared to predicted, likely due to significant tissue contraction ranging from 0 to 43%. There was no significant heat sink effect. Mean hospital stay was 1.93 days, and only 2 patients stayed for more than 3 days. Complications included pneumothorax requiring drainage (6.8%), post-ablation reaction (4.5%), pleural effusion (4.5%), hemoptysis (2.3%) and bronchopleural fistula (2.3%). After median follow up of 1 year, none of the nodules had evidence of progression.
Bronchoscopic transbronchial microwave ablation is a novel, feasible and safe technique for treatment of early stage lung cancers, lung metastases or highly suspicious lung nodules.
Legal entity responsible for the study
Research Grants Council (RGC) University Grant Committee Hong Kong, no: 14119019.
R.W. Lau: Advisory/Consultancy: Medtronic; Advisory/Consultancy: Siemens Healthineer. C.S. Ng: Advisory/Consultancy: Johnson & Johnson; Advisory/Consultancy: Medtronic; Advisory/Consultancy: Siemens Healthineer. All other authors have declared no conflicts of interest.