小狗阅读会员会员
有解析的医学SCI阅读工具

扫码登录小狗阅读

阅读SCI医学文献

Augmented fluoroscopic bronchoscopy (AFB) versus percutaneous computed tomography-guided dye localization for thoracoscopic resection of small lung nodules: a propensity-matched study

增强透视支气管镜 (AFB) 与经皮计算机断层扫描引导染料定位在胸腔镜下肺小结节切除术中的应用: 一项倾向匹配研究

  • 影响因子:3.18
  • DOI:10.1007/s00464-019-07334-4
  • 作者列表:"Yang, Shun-Mao","Chen, Yi-Chang","Ko, Wei-Chun","Huang, Hsin-Chieh","Yu, Kai-Lun","Ko, Huan-Jang","Huang, Pei-Ming","Chang, Yeun-Chung
  • 发表时间:2020-01-13
Abstract

Background Dye localization is a useful method for the resection of unidentifiable small pulmonary lesions. This study compares the transbronchial route with augmented fluoroscopic bronchoscopy (AFB) and conventional transthoracic CT-guided methods for preoperative dye localization in thoracoscopic surgery. Methods Between April 2015 and March 2019, a total of 231 patients with small pulmonary lesions who received preoperative dye localization via AFB or percutaneous CT-guided technique were enrolled in the study. A propensity-matched analysis, incorporating preoperative variables, was used to compare localization and surgical outcomes between the two groups. Results After matching, a total of 90 patients in the AFB group ( N  = 30) and CT-guided group ( N  = 60) were selected for analysis. No significant difference was noted in the demographic data between both the groups. Dye localization was successfully performed in 29 patients (96.7%) and 57 patients (95%) with AFB and CT-guided method, respectively. The localization duration (24.1 ± 8.3 vs. 21.4 ± 12.5 min, p  = 0.297) and equivalent dose of radiation exposure (3.1 ± 1.5 vs. 2.5 ± 2.0 mSv, p  = 0.130) were comparable in both the groups. No major procedure-related complications occurred in either group; however, a higher rate of pneumothorax (0 vs. 16.7%, p  = 0.029) and focal intrapulmonary hemorrhage (3.3 vs. 26.7%, p  = 0.008) was noted in the CT-guided group. Conclusion AFB dye marking is an effective alternative for the preoperative localization of small pulmonary lesions, with a lower risk of procedure-related complications than the conventional CT-guided method.

摘要

背景染料定位是切除无法识别的肺部小病灶的有用方法。本研究比较了胸腔镜手术中术前染料定位的经支气管途径与增强透视支气管镜 (AFB) 和常规经胸 CT 引导方法。方法 2015年4月至 2019年3月,231 例肺部小病灶患者接受术前 AFB 或经皮 CT 引导下染料定位。采用倾向匹配分析,结合术前变量,比较两组的定位和手术结果。结果匹配后,AFB 组 (N = 30) 和 CT 引导组 (N = 60) 共 90 例患者进行分析。两组之间的人口统计学数据无显著差异。用 AFB 和 CT 引导的方法分别成功地对 29 例患者 (96.7%) 和 57 例患者 (95%) 进行了染料定位。定位持续时间 (24.1 ± 8.3 vs. 21.4 ± 12.5 min,p = 0.297) 和等效辐射剂量 (3.1 ± 1.5 vs. 2.5 ± 2.0 mSv,p = 0.130) 在两组中具有可比性。两组均无重大手术相关并发症发生; 然而,气胸发生率较高 (0 vs. 16.7%,p = 0.029) 和局灶性肺内出血 (3.3 vs. 26.7%,p = 0.008)。结论 AFB 染色标记是肺部小病灶术前定位的有效方法,与常规 CT 引导方法相比,手术相关并发症的风险较低。

关键词:
阅读人数:7人
下载该文献
小狗阅读

帮助医生、学生、科研工作者解决SCI文献找不到、看不懂、阅读效率低的问题。提供领域精准的SCI文献,通过多角度解析提高文献阅读效率,从而使用户获得有价值研究思路。

相关文献
影响因子:3.18
发表时间:2020-01-13
来源期刊:Surgical Endoscopy
DOI:10.1007/s00464-019-07334-4
作者列表:["Yang, Shun-Mao","Chen, Yi-Chang","Ko, Wei-Chun","Huang, Hsin-Chieh","Yu, Kai-Lun","Ko, Huan-Jang","Huang, Pei-Ming","Chang, Yeun-Chung"]

METHODS:Background Dye localization is a useful method for the resection of unidentifiable small pulmonary lesions. This study compares the transbronchial route with augmented fluoroscopic bronchoscopy (AFB) and conventional transthoracic CT-guided methods for preoperative dye localization in thoracoscopic surgery. Methods Between April 2015 and March 2019, a total of 231 patients with small pulmonary lesions who received preoperative dye localization via AFB or percutaneous CT-guided technique were enrolled in the study. A propensity-matched analysis, incorporating preoperative variables, was used to compare localization and surgical outcomes between the two groups. Results After matching, a total of 90 patients in the AFB group ( N  = 30) and CT-guided group ( N  = 60) were selected for analysis. No significant difference was noted in the demographic data between both the groups. Dye localization was successfully performed in 29 patients (96.7%) and 57 patients (95%) with AFB and CT-guided method, respectively. The localization duration (24.1 ± 8.3 vs. 21.4 ± 12.5 min, p  = 0.297) and equivalent dose of radiation exposure (3.1 ± 1.5 vs. 2.5 ± 2.0 mSv, p  = 0.130) were comparable in both the groups. No major procedure-related complications occurred in either group; however, a higher rate of pneumothorax (0 vs. 16.7%, p  = 0.029) and focal intrapulmonary hemorrhage (3.3 vs. 26.7%, p  = 0.008) was noted in the CT-guided group. Conclusion AFB dye marking is an effective alternative for the preoperative localization of small pulmonary lesions, with a lower risk of procedure-related complications than the conventional CT-guided method.

关键词: 暂无
翻译标题与摘要 下载文献
影响因子:3.31
发表时间:2020-01-02
DOI:10.1007/s10916-019-1481-4
作者列表:["Matava, Clyde","Pankiv, Evelina","Raisbeck, Sam","Caldeira, Monica","Alam, Fahad"]

METHODS:Background The use of artificial intelligence, including machine learning, is increasing in medicine. Use of machine learning is rising in the prediction of patient outcomes. Machine learning may also be able to enhance and augment anesthesia clinical procedures such as airway management. In this study, we sought to develop a machine learning algorithm that could classify vocal cords and tracheal airway anatomy real-time during video laryngoscopy or bronchoscopy as well as compare the performance of three novel convolutional networks for detecting vocal cords and tracheal rings. Methods Following institutional approval, a clinical dataset of 775 video laryngoscopy and bronchoscopy videos was used. The dataset was divided into two categories for use for training and testing. We used three convolutional neural networks (CNNs): ResNet, Inception and MobileNet. Backpropagation and a mean squared error loss function were used to assess accuracy as well as minimize bias and variance. Following training, we assessed transferability using the generalization error of the CNN, sensitivity and specificity, average confidence error, outliers, overall confidence percentage, and frames per second for live video feeds. After the training was complete, 22 models using 0 to 25,000 steps were generated and compared. Results The overall confidence of classification for the vocal cords and tracheal rings for ResNet, Inception and MobileNet CNNs were as follows: 0.84, 0.78, and 0.64 for vocal cords, respectively, and 0.69, 0.72, 0.54 for tracheal rings, respectively. Transfer learning following additional training resulted in improved accuracy of ResNet and Inception for identifying the vocal cords (with a confidence of 0.96 and 0.93 respectively). The two best performing CNNs, ResNet and Inception, achieved a specificity of 0.985 and 0.971, respectively, and a sensitivity of 0.865 and 0.892, respectively. Inception was able to process the live video feeds at 10 FPS while ResNet processed at 5 FPS. Both were able to pass a feasibility test of identifying vocal cords and tracheal rings in a video feed. Conclusions We report the development and evaluation of a CNN that can identify and classify airway anatomy in real time. This neural network demonstrates high performance. The availability of artificial intelligence may improve airway management and bronchoscopy by helping to identify key anatomy real time. Thus, potentially improving performance and outcomes during these procedures. Further, this technology may theoretically be extended to the settings of airway pathology or airway management in the hands of experienced providers. The researchers in this study are exploring the performance of this neural network in clinical trials.

关键词: 暂无
翻译标题与摘要 下载文献
影响因子:3.84
发表时间:2020-01-01
来源期刊:Chest
DOI:10.1016/j.chest.2019.06.018
作者列表:["Dhooria S","Chaudhary S","Ram B","Sehgal IS","Muthu V","Prasad KT","Aggarwal AN","Agarwal R"]

METHODS:BACKGROUND:The optimal mode of delivering topical anesthesia during flexible bronchoscopy remains unknown. This article compares the efficacy and safety of nebulized lignocaine, lignocaine oropharyngeal spray, or their combination. METHODS:Consecutive subjects were randomized 1:1:1 to receive nebulized lignocaine (2.5 mL of 4% solution, group A), oropharyngeal spray (10 actuations of 10% lignocaine, group B), or nebulization (2.5 mL, 4% lignocaine) and two actuations of 10% lignocaine spray (group C). The primary outcome was the subject-rated severity of cough according to a visual analog scale. The secondary outcomes included bronchoscopist-rated severity of cough and overall procedural satisfaction on a visual analog scale, total lignocaine dose, subject's willingness to undergo a repeat procedure, adverse reactions to lignocaine, and others. RESULTS:A total of 1,050 subjects (median age, 51 years; 64.8% men) were included. The median (interquartile range) score for subject-rated cough severity was significantly lower in group B compared to group C or group A (4 [1-10] vs 11 [4-24] vs 13 [5-30], respectively; P < .001). The bronchoscopist-rated severity of cough was also the least (P < .001), and the overall satisfaction was highest in group B (P < .001). The cumulative lignocaine dose administered was the least in group B (P < .001). A significantly higher proportion of subjects (P < .001) were willing to undergo a repeat bronchoscopy in group B (73.7%) than in groups A (49.1%) and C (59.4%). No lignocaine-related adverse events were observed. CONCLUSIONS:Ten actuations of 10% lignocaine oropharyngeal spray were superior to nebulized lignocaine or their combination for topical anesthesia during diagnostic flexible bronchoscopy. TRIAL REGISTRY:ClinicalTrials.gov; No.: NCT03109392; URL: www.clinicaltrials.gov.

翻译标题与摘要 下载文献
方向

复制标题
发送后即可在该邮箱或我的下载查看该文献
发送
该文献默认存储到我的下载

科研福利

报名咨询

建议反馈
问题标题:
联系方式:
电子邮件:
您的需求: