Feasibility And Safety Of Enb Guided Microwave Ablation For Lung Cancer: A Preliminary Report

Microwave ablation (MWA) was a relatively new method, in which one or more microwave antennas are inserted inside the tumor mass, the antennas produce thermal energy that causes coagulative necrosis of neoplastic cells and the surrounding parenchyma. Most of the MWA treatment for lung cancer are introduced percutaneous under CT guidance, electromagnetic bronchoscopy ENB is recommended for peripheral lesions difficult to reach with conventional bronchoscopy, and has been used for the biopsy and treatment, it could be used for inserting MWA antenna for further treatment, this study was performed with the main aim of evaluating the safety and effectiveness of patients with lung cancer undergoing MWA under ENB guidance. All ENB procedures use the superDimensionTM navigation system version 7.0 (Medtronic, Minneapolis, MN). After pathway planning using the procedure-planning software, ENB procedure were performed under conscious sedation with a combination of midazolam and fentanyl. Patients undergoing ENB were not intubated but continued breathing spontaneously throughout the procedure. After tissue sampling, the antenna of MWA was then introduced into the tumor under the guidance of ENB. The duration of each MWA application was based on the size and location of the lesion measured by the pre-operative CT scan. From June 2019 to February 2020, seven patients(2M:5F) with 7 lesions (10-24mm) met the inclusion criteria and underwent MWA, with 5 of them have bronchus sign, all the lesions were reached and received MWA treatment, five of the patients get simultaneous surgical resection for other pulmonary nodule. One of the ENB guided ablation has mild hemoptysis and pneumonia after treatment, after intravenous antibiotic and coagulation treatment, the patient recovered. Our preliminary experience shows ENB guided microwave ablation is safe and feasible, bronchus sign on CT seems a important factor for accurate navigation.