ABSTRACT
OBJECTIVE: The aim of this study was to evaluate the clinical value of computed tomographyguided localization needle (LN) and methylene blue (MB) for pulmonary nodule localization. MATERIALS AND METHODS: Between November 2019 and January 2022, 547 patients underwent computed tomography-guided LN (n=171) or MB (n=376) localization and video-assisted thoracoscopic surgery (VATS) resection. RESULTS: In total, 171 and 376 nodules were localized via LN and MB, respectively, with respective technical localization success rates of 92.98 % and 88.56 % (p = 0.111). The pulmonary nodule localization time was significantly shorter for the MB group than for the LN group (p < 0.05). However, the rates of total complication, chest pain, and cough were significantly lower in the LN group (χ2 = 8.251/25.092/5.127, all p < 0.05). Furthermore, the LN group had a shorter VATS time than the MB group (p < 0.05). The VATS achieved a 100% operation success rate in both groups, and there was no significance between groups with respect to the types of surgery (p > 0.05) or the blood loss (p > 0.05). Moreover, logistic regression analysis showed that the localization technique was an independent risk factor for total complications and chest pain. CONCLUSION: Both techniques can effectively localize pulmonary nodules before VATS. MB had a shorter localization time, but the LN had a shorter VATS time and a lower incidence of complications, especially chest pain.
Subject(s)
Lung Neoplasms , Multiple Pulmonary Nodules , Solitary Pulmonary Nodule , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Methylene Blue , Solitary Pulmonary Nodule/diagnostic imaging , Solitary Pulmonary Nodule/surgery , Retrospective Studies , Multiple Pulmonary Nodules/diagnostic imaging , Multiple Pulmonary Nodules/surgery , Tomography, X-Ray Computed/methods , Chest PainABSTRACT
BACKGROUND: To analyze the perioperative safety and effectiveness of chemoembolization with CalliSpheres drug-eluting beads (DEBs) loaded with irinotecan (DEBIRI) in the treatment of unresectable colorectal cancer liver metastases (CRCLM). METHODS: The clinical data of 16 colorectal cancer patients with postoperative liver metastases who were treated with chemoembolization using DEBIRI in our center from March 2017 to December 2018 were retrospectively analyzed. The treatment responses 3 and 6 months after the chemoembolization was evaluated with the modified Response Evaluation Criteria in Solid Tumors (mRECIST). The clinical complications were recorded and graded. Changes in blood cells, liver function, and tumor marker were analyzed before treatment and during follow-up. RESULTS: A total of 46 DEBIRI sessions were performed in 16 patients. The success rate was 100.0%. The main postoperative complications included right upper quadrant pain (76.1%), hypertension (87.0%), nausea (89.1%), and vomiting (84.8%), which were grade 1 to 2 events; one patient suffered from acute cholecystitis (2.2%), a grade 3 event. According to mRECIST, the complete response rate, partial response rate, objective response rate, and disease control rate were 0.0%, 68.7%, 68.7%, and 100.0% 3 months after chemoembolization and 0.0%, 81.2%, 81.2%, and 93.7% 6 months after the intervention. As shown by blood biochemistry, the carcinoembryonic antigen (CEA) significantly differed before treatment and during follow-up (P<0.01), while blood cells and liver function showed no significant differences (all P>0.05). CONCLUSIONS: In this preliminary clinical study, chemoembolization with DEBIRI is safe and effective in treating unresectable CRCLM. However, more prospective multicenter clinical trials with larger sample sizes are required to confirm our findings further.
