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- Ensaio Clínico NCT07595120
Application of Electromagnetic Navigation System in Pulmonary Nodule Localization
Electromagnetic Navigation-Guided Versus CT-Guided Localization of Pulmonary Nodules: A Multicenter, Prospective, Randomized Controlled Trial
Visão geral do estudo
Status
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: Shenghao Huang
- Número de telefone: +86 153 5656 1656
- E-mail: huangshplus5@163.com
Locais de estudo
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Shanghai, China
- Shanghai Pulmonary Hospital
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Contato:
- Haifeng Wang
- Número de telefone: +8602156561656
- E-mail: huangshplus5@163.com
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
- Age 18-80 years, regardless of gender;
- Solitary single nodule, scheduled for lung nodule puncture and localization;
- Chest CT (lung window mode) showing a maximum nodule diameter ≤ 2 cm;
- Eastern Cooperative Oncology Group (ECOG) performance status score 0-2;
- Voluntary participation, with signed informed consent.
Exclusion Criteria:
- Not suitable for video-assisted thoracoscopic surgery;
- The distance between the center of the lesion and the dome of the diaphragm is < 3 cm;
- History of thoracic adhesion due to previous thoracotomy or pleural infection;
- Patients judged by the investigator to be unsuitable for preoperative transthoracic or transbronchial localization;
- Inability to complete follow-up or poor compliance.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Experimental: Electromagnetic Navigation Localization Group
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Performed by an experienced thoracic surgeon or interventional radiologist under general or local anesthesia, the procedure is guided by an electromagnetic navigation system.
The procedural steps include: 1) preoperative import of the patient's CT data into the navigation system for path planning; 2) intraoperative coupling of the positioning sensor with the puncture instrument; 3) under real-time three-dimensional imaging guidance of the electromagnetic navigation system, performing percutaneous puncture to accurately place a positioning guidewire / microcoil / dye near the target pulmonary nodule; 4) postoperative CT scan to confirm the localization.
This is a single-session procedure.
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Comparador Ativo: CT-Guided Localization Group
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Performed by an experienced thoracic surgeon or interventional radiologist under local anesthesia, the procedure is guided using a CT scanner.
The steps include: 1) positioning the patient appropriately and performing a CT scan to determine the puncture site and path; 2) employing CT fluoroscopy or intermittent CT scanning for real-time guidance; 3) under CT image guidance, performing a percutaneous puncture to place a localization guidewire / microcoil / dye near the target pulmonary nodule; 4) performing a repeat CT scan post-procedure to confirm the localization position.
This is a single-session procedure.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Success rate of intraoperative localization of lung nodules
Prazo: Day 0 (Intraoperative)
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Thoracoscopic exploration enables accurate identification and localization of markers (e.g., contrast dye, microcoils, etc.), with the distance between the center of the marker or the main imaging area and the center of the target nodule being ≤20 mm, and ultimately successfully guides the resection of the target lesion.
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Day 0 (Intraoperative)
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Localization Accuracy
Prazo: Day 0 (Intraoperative)
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The shortest physical distance (unit: mm) between the actual localization marker point (e.g., the center of the dye) and the outer edge of the nodular lesion in the resected specimen.
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Day 0 (Intraoperative)
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Location Procedure Time
Prazo: Day 0 (Intraoperative)
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CT-guided group: Time from the start of the initial localization planning CT scan to the completion of marker/needle deployment and withdrawal of instruments from the body surface. Electromagnetic navigation group: Time from when the bronchoscope passes the vocal cords to the completion of marker deployment and withdrawal of the guiding instrument (unit: min). |
Day 0 (Intraoperative)
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Conversion Rate
Prazo: Day 0 (Intraoperative)
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The proportion of subjects in whom conversion from complete thoracoscopy to thoracotomy, or from the planned sublobar resection (wedge/segment) to an extended resection (e.g., lobectomy), was necessitated due to failure to locate the lesion, insufficient surgical margin resulting from excessive localization error, or severe complications related to localization (such as major hemorrhage).
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Day 0 (Intraoperative)
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Complication Rate
Prazo: Day 0 through hospital discharge or Day 7 postoperatively, whichever comes first
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Record the incidence of all complications related to the localization procedure.
In addition to complications common to percutaneous approaches, such as pneumothorax and intrathoracic hemorrhage, airway-related complications, including airway mucosal injury/bleeding, bronchospasm, and severe hypoxemia, should be systematically documented.
Assessment should be performed based on the adverse event grading criteria.
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Day 0 through hospital discharge or Day 7 postoperatively, whichever comes first
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Radiation Exposure
Prazo: Day 0 (Intraoperative)
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Dose-length product (DLP) value of radiation received by the patient, as recorded by the CT scanner (unit: mGy·cm).
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Day 0 (Intraoperative)
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Operative Time
Prazo: Day 0 (Intraoperative)
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Time from the initiation of the skin incision for thoracoscopy to the completion of wound closure (unit: min).
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Day 0 (Intraoperative)
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Early Postoperative Pain Score
Prazo: Day 0 (immediately after localization); 24 hours postoperatively
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Visual Analog Scale (VAS) or Numeric Rating Scale (NRS), scored from 0 to 10 points (with 0 representing no pain and 10 representing the most severe pain).
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Day 0 (immediately after localization); 24 hours postoperatively
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Haifeng Wang, Shanghai Pulmonary Hospital, Shanghai, China
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- IRB-K26-427
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