Artificial pleural effusion-assisted intraoperative ultrasound for the localization of pulmonary tumors during video-assisted thoracic surgery.

BACKGROUND

Intraoperative localization of pulmonary nodules (PNs) is a technical support for video-assisted thoracic surgery (VATS). Failure to accurately localize PNs will necessitate conversion to conventional open chest surgery or transfer to the hybrid operation room, which highlights the importance of intraoperative ultrasound (IOUS) for identifying lesions. We found that PNs could be better visualized with the help of artificial pleural effusion (APE). Therefore, the aim of this study was to investigate the feasibility of APE-assisted IOUS for the visualization of PNs.

METHODS

Patients who underwent VATS from December 2023 to August 2024 were included in this study. APE was established using saline, and APE-assisted IOUS was applied to localize and make the initial determination of nature. After identifying the suspicious lesions, the surface of the lobe where the nodules were located was marked. The feasibility of APE-assisted IOUS for identifying the nodules was determined based on pathology.

RESULTS

In total, 16 PNs of 15 patients included were successfully identified with APE-assisted IOUS. Spearman's correlation analysis showed that there was a significant correlation between the maximum diameter of pulmonary lesions measured by preoperative computed tomography (CT) and IOUS (ρ=0.889, P<0.01). The median localization time with APE-assisted IOUS was 1.00 minute.

CONCLUSIONS

APE-assisted IOUS can accurately localize PNs, minimizing surgical time and increasing the efficiency of resection.