【World 1st】Thoracic surgical team from CU Medicine achieves breakthrough in the treatment of lung metastasis. The team successfully performed non-invasive bronchoscopic microwave ablation (BMA) and uniportal video-assisted thoracic surgery (uVATS) at a single operation in hybrid operating room for a 68-year-old hepatocellular carcinoma patient with multiple lung metastases, treating four lesions located in different parts of the right lung and preserving most of the lung function. This is world’s first attempt of one-stop hybrid treatment of multiple lung metastases with BMA and uVATS in hybrid operating room. The case report was published in the international medical journal The Annals of Thoracic Surgery.
Professor Calvin NG from CU Medicine’s thoracic surgical team says, “Multifocal lung metastasis is traditionally a challenge to manage. Heterogeneity in size, location and depth of the multiple lesions are decisive factors to treatment options. In this case, ideally all the four metastases should be surgically resected if possible. However, the loss of lung volume precludes our team from considering this as an option and there are other practical difficulties in the resection. Therefore, we decided to implement a multimodal treatment with hybrid theatre facilities, that is to combine BMA and uniportal VATS in one operation, so as to preserve most lung tissues.”
The team confirmed the position of four metastases with cone-beam CT scan, which were on the right middle lobe and right upper lobe. The two lesions on the upper lobe were deep in the anterior segment with size smaller than 1cm and thus BMA was performed to destroy them. For the other two bigger lesions at the periphery of the middle lobe, doctors decided to remove them with uniportal VATS.
“Conventionally, multimodal management for metastases were carried out in separate locations in staged manner that may require patients to have multiple hospital admissions and be anesthetised more than once. The hybrid operating room with cone-beam computed tomography can integrate three procedures into a single operation setting: high-end radiology, state-of-the-art interventional bronchoscopy and advanced minimally invasive surgery. This allows a tailor made one-stop management of lung tumours, particularly for multiple, subcentimeter lesions. Furthermore, avoiding multiple hospital admissions in the current era of COVID-19 could reduce exposure of patients to high risk areas,” Professor Ng added.
Professor Ng and his team is renowned in hybrid operating room thoracic procedures, and pioneers in the use of electromagnetic navigation bronchoscopy and BMA in the Asia Pacific region.
Details of the report: https://bit.ly/2CXsEPv
文章來自: CUHK Medicine