P-252
INTRAOPERATIVE ELECTROMAGNETIC NAVIGATION BRONCHOSCOPY FOR THORACOSCOPIC RESECTION OF LUNG TUMOUR

Objectives: As a result of increased use of low dose CT, more patients with pulmonary nodules, many with subcentimeter lesions, are being referred to thoracic surgeons, some with concern for primary lung tumour and others with possible metastatic lung lesions. Obtaining a definitive diagnosis of these lesions is difficult. Electromagnetic navigational bronchoscopy (ENB)-guided pleural dye marking followed by VATS is a novel alternative technique for definitive diagnosis. The main objective of this study was to evaluate the feasibility and our initial experience with intraoperative ENB and minimally invasive surgery for diagnosis of lung lesions.

Methods: Between February 2016 and January 2017, we retrospectively reviewed the clinical characteristics, ENB design, operative methods, and treatment outcomes of 17 patients with lung tumour(s).

Results: The mean patient age was 63.8±8.2 years. There are 4 women and 13 men in this study. The ENB-guided biopsy yield rate was 23.5%. The successful rate of dye marking was 88.2%. There were 3 patients undergoing ENB tumour ablation via photodynamic therapy (PDT). There was no procedure-related mortality. Fourteen patients with lung lesions were successfully operated, either by conventional or uniportal VATS, while 3 patients were ablated with PDT smoothly.

Conclusions: Electromagnetic navigation bronchoscopy (ENB) plays a central role in the treatment of lung cancer, either primary or metastatic. Biopsy yield rate is low, while intraoperative localizing and marking small pulmonary nodules is effective and safe before minimally invasive resection. Last but not least, direct tumour ablation via PDT showed promising result in our initial experience. In summary, thoracic surgeons should further investigate this method and incorporate it into their armamentarium.

Disclosure: No significant relationships.