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Effect of patient position during virtual-assisted lung mapping.
Masahiro Yanagiya1,2, Jun Matsumoto1, Hirokazu Yamaguchi1
1Department of General Thoracic Surgery, NTT Medical Center Tokyo, Tokyo, Japan.
Journal of Thoracic Disease
|March 14, 2019
Summary
Patient position during virtual-assisted lung mapping (VAL-MAP) significantly impacts dye marking quality. The lateral position resulted in a higher rate of appropriate markings compared to the supine position for lung nodule localization.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Medical Imaging
Background:
- Virtual-assisted lung mapping (VAL-MAP) is a bronchoscopic dye-marking technique used preoperatively.
- Marking failures occur in approximately 10% of VAL-MAP procedures.
- Investigating factors influencing VAL-MAP marking quality is crucial for improving surgical outcomes.
Purpose of the Study:
- To evaluate the impact of patient positioning during dye injection on the quality of virtual-assisted lung mapping (VAL-MAP) markings.
- To determine if the supine or lateral position yields superior marking accuracy.
Main Methods:
- Retrospective review of 14 patients undergoing VAL-MAP for pulmonary nodules between December 2016 and September 2017.
- Comparison of marking quality (appropriate vs. inappropriate) between patients in the supine (n=6) and lateral (n=8) positions during dye injection.
- Statistical analysis using Fisher exact test and logistic regression to assess the association between position and marking appropriateness.
Main Results:
- A total of 48 markings were analyzed (21 supine, 27 lateral).
- The appropriate marking rate was significantly higher in the lateral position group (88%) compared to the supine group (57%) (P=0.02).
- Lateral positioning was independently associated with appropriate markings (P=0.014).
Conclusions:
- The lateral position during dye injection may improve the quality of markings in virtual-assisted lung mapping (VAL-MAP).
- This finding suggests that optimizing patient positioning can enhance the efficacy of VAL-MAP for lung nodule localization.
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