Integration of mobile CT and basal anesthesia for pain-free preoperative localization of small pulmonary nodules: a retrospective cohort study

移动式CT联合基础麻醉用于无痛术前定位小型肺结节:一项回顾性队列研究

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Abstract

OBJECTIVE: To explore the application of mobile CT combined with basal anesthesia in preoperative painless localization of small pulmonary nodules and evaluate its safety and effectiveness. METHODS: The clinical data of patients who underwent precise localization of pulmonary nodules via mobile CT combined with basal anesthesia in the Department of Thoracic Surgery, Affiliated Nanjing Brain Hospital, Nanjing Medical University October 2024–February 2025 were retrospectively analyzed. The basic information and perioperative outcomes of the entire group were analyzed. RESULTS: A total of 100 patients, 33 males and 67 females aged 19–86 years, were included. The preoperative localization success rate for 100 patients with small pulmonary nodules was 100.0%, with an average localization time of 14.51 ± 4.01 min.The localization-related complications included 1 case of intrapulmonary hemorrhage, 1 case of pneumothorax, and 2 cases of localization needle displacement, with no complications such as hemoptysis or pleural reaction. The time interval from completion of localization to the start of surgery was 28.83 ± 3.55 min. All patients underwent successful single-port thoracoscopic resection of pulmonary nodules without conversion to open thoracotomy. The average operative time was 62.72 ± 41.50 min. The surgery-related complications included one case of intraoperative bleeding, which was promptly controlled via endoscopic hemostasis. The average postoperative chest tube retention time was 3.60 ± 1.30 days, and the average hospital stay was 6.12 ± 1.15 days. Postoperative pathological results confirmed that all the nodules had a margin distance greater than 2 cm from the resection edge. The 100 patients were divided into two groups: one group underwent mobile CT-guided localization under lidocaine local anesthesia, while the other group received mobile CT-guided localization under basal anesthesia. Analysis of postlocalization pain scores revealed that basal anesthesia achieved superior analgesic efficacy (P < 0.05). CONCLUSION: The combination of mobile CT with basal anesthesia enables painless and precise preoperative localization of pulmonary nodules, effectively reducing the incidence of localization-related complications, shortening surgical waiting times, and ensuring the safety and efficacy of preoperative localization in patients with pulmonary nodules. This approach further enhances patient comfort during the procedure and demonstrates certain clinical application value.

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