Enhanced recovery after surgery for percutaneous CT-guided microwave ablation of lung tumors: A single-center retrospective cohort study

Enhanced recovery using lung tumour thermal ablation in scleroderma associated interstitial lung disease

Image-guided thermal ablation is an alternative treatment for non-small cell lung cancer and can be performed in patients for whom general anaesthesia is not desired or contraindicated. This minimally invasive treatment is a promising approach in patients with early-stage lung cancer who are considered inoperable due to comorbidities. This short report describes an improved thermal ablation technique that considers the complexity of treating lung carcinoma in scleroderma-associated interstitial lung disease.

Factors retarding enhanced recovery from thermal ablation of liver tumors: A single-center prospective study

PURPOSE

To evaluate the risk factors that may delay enhanced recovery in the ablation of liver tumors.

METHODS

A total of 310 patients who underwent ultrasound-guided ablation of liver tumors under general anesthesia were prospectively enrolled. Baseline data, intraoperative parameters, and postoperative events were evaluated. Postoperative pain was scored using the visual analog scale (VAS). Logistic regression analysis was conducted for univariate and multivariate analyses.

RESULTS

The study included 42 females (13.5%) and 268 males (86.5%). The mean age of the sample was 57 ± 11 years old. The average length of stay (LOS) was 4.3 ± 2.4 days. A total of 199 out of 310 patients (64.2%) experienced moderate to severe pain (VAS score > 3). Seventy out of 310 patients (22.6%) experienced other complications. In the multivariable analysis, the number of lesions [odds ratio (95% confidence interval): 3.23 (2.15-4.84); P < 0.001], maximum diameter of lesions [1.12 (1.07-1.17), P < 0.001], and smallest distance between the lesions and the liver capsule [0.91 (0.89-0.94), P < 0.001] were risk factors for postoperative pain (VAS > 3). A history of alcohol consumption [2.62 (1.33-5.19), P = 0.005] was a risk factor for other complications. Surgical history [0.40 (0.24-0.67), P = 0.001] was a protective factor against LOS. Total operation time [1.01, 1.00-1.01, P = 0.009] was a mild risk factor for LOS.

CONCLUSION

The number of lesions, maximum diameter of the lesions, smallest distance between the lesions and the liver capsule, total operation time, and a history of alcohol use were risk factors that may delay enhanced recovery in patients undergoing ablation of liver tumors. These findings may provide evidence to promote the use of the enhanced recovery after surgery protocol.

Evaluation of robotic-assisted navigation system for CT-guided thoracic and abdominal lesion puncture: A prospective clinical study

INTRODUCTION

The study aims to compare the accuracy and safety of robotic-assisted navigation puncture to freehand puncture during computed tomography (CT)-guided percutaneous needle insertion in the chest and abdomen.

METHODS

A total of 60 patients required percutaneous puncture procedures, with 40 involving the chest and 20 involving the abdomen. Eligible patients were randomly assigned to two groups. The test group punctured using a robotic-assisted navigation system, whereas the control group punctured manually. The primary outcome assessment standards are single puncture success rates, with the number of needle modifications and CT scan timings during the procedure serving as supplementary outcome evaluation standards. The Wilcoxon rank sum test is used for the comparison.

RESULTS

The puncture procedure's success rates after just one puncture: The test group punctures accurately without adjusting the puncture needle, while the control group uses an average number of 1.73 ± 1.20 pins. The once-puncture success rate of robot navigation puncture is considerably higher than that of bare-handed puncture (P < 0.001). The times of CT scan are necessitated when the puncture is in place: the average times in the test group is 3.03 ± 0.18 times, while the control group is 4.70 ± 1.24 times.

CONCLUSION

In conclusion, the robotic-assisted navigation system improves puncture accuracy while reducing the need for needle corrections during percutaneous puncture procedures. It also shortens CT scans and reduces radiation exposure from X-rays.