Cone-beam computed tomography image-guided percutaneous microwave ablation for lung nodules in a hybrid operating room: an initial experience

ObjectivesThe experience of thermal ablation of lung lesions is limited, especially performing the procedure under localisation by cone-beam CT in the hybrid operation room (HOR). Here, we present the experience of microwave ablation (MWA) of lung nodules in the HOR.MethodsWe reviewed patients who underwent image-guide percutaneous MWA for lung nodules in the HOR under general anaesthesia between July 2020 and July 2022. The workflow in the HOR including the pre-procedure preparation, anaesthesia consideration, operation methods, and postoperative care was clearly described.ResultsForty lesions in 33 patients who underwent MWA under general anaesthesia (GA) in the HOR were analysed. Twenty-seven patients had a single pulmonary nodule, and the remaining six patients had multiple nodules. The median procedure time was 41.0 min, and the median ablation time per lesion was 6.75 min. The median global operation room time was 115.0 min. The median total dose area product was 14881 mu Gym2. The median ablation volume was 111.6 cm3. All patients were discharged from the hospital with a median postoperative stay of 1 day. Four patients had pneumothorax, two patients had pleural effusion during the first month of outpatient follow-up, and one patient reported intercostal neuralgia during the 3-month follow-up.ConclusionsThermal ablation of pulmonary nodules under GA in the HOR can be performed safely and efficiently if we follow the workflow provided. The procedure provides an alternative to managing pulmonary nodules in patients.Clinical relevance statementThermal ablation of pulmonary nodules under GA in the HOR can be performed safely and efficiently if the provided workflow is followed.Key Points center dot We tested the feasibility of microwave ablation of lung lesions performed in a hybrid operating room.center dot To this end, we provide a description of microwave ablation of the lung under cone-beam CT localisation.center dot We describe a workflow by which ablation of the pulmonary nodule can be performed safely under general anaesthesia.Key Points center dot We tested the feasibility of microwave ablation of lung lesions performed in a hybrid operating room.center dot To this end, we provide a description of microwave ablation of the lung under cone-beam CT localisation.center dot We describe a workflow by which ablation of the pulmonary nodule can be performed safely under general anaesthesia.Key Points center dot We tested the feasibility of microwave ablation of lung lesions performed in a hybrid operating room.center dot To this end, we provide a description of microwave ablation of the lung under cone-beam CT localisation.center dot We describe a workflow by which ablation of the pulmonary nodule can be performed safely under general anaesthesia.

Automated summary

This study reviewed patients who underwent image-guided percutaneous MWA for lung nodules in the HOR. The workflow in the HOR, including pre-procedure preparation, anesthesia considerations, operation methods, and postoperative care, was clearly described.