Prospective study on image-guided navigation surgery for pelvic malignancies.
electromagnetic tracking
locally advanced rectal cancer
pelvic recurrences
surgical navigation
Journal
Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
received:
12
10
2018
accepted:
11
12
2018
pubmed:
26
12
2018
medline:
2
3
2019
entrez:
25
12
2018
Statut:
ppublish
Résumé
Surgery of advanced tumors and lymph nodes in the pelvis can be challenging due to the narrow pelvic space and vital surrounding structures. This study explores the application of a novel electromagnetic navigation system to guide pelvic surgery. This was a prospective study on surgery for malignancies in the pelvis. Preoperatively obtained imaging was used to create a patient-specific three-dimensional (3D) roadmap. In the operating room, the 3D roadmap was registered to an intraoperative computed tomography scan. A tracked pointer was used during surgery for guidance. Primary endpoint was safety and feasibility, secondary endpoints were accuracy and usability. Twenty-eight colorectal, four liposarcomas, and one gynecological patient were included. There were no safety issues. Navigation was feasible in 31 patients. The mean target registration errors of 4.0 and 6.3 mm were achieved for straight and French position, respectively. In seven of seven patients with a locally advanced rectal tumor and in seven of eight patients with recurrences, negative margins were achieved. Thirty-three of 36 target lymph nodes were successfully removed. Surgeons using the system indicated faster localization of the tumor and improved decisiveness. This novel surgical navigation system was safe and feasible during pelvic surgery and can facilitate its users.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
Surgery of advanced tumors and lymph nodes in the pelvis can be challenging due to the narrow pelvic space and vital surrounding structures. This study explores the application of a novel electromagnetic navigation system to guide pelvic surgery.
METHODS
METHODS
This was a prospective study on surgery for malignancies in the pelvis. Preoperatively obtained imaging was used to create a patient-specific three-dimensional (3D) roadmap. In the operating room, the 3D roadmap was registered to an intraoperative computed tomography scan. A tracked pointer was used during surgery for guidance. Primary endpoint was safety and feasibility, secondary endpoints were accuracy and usability.
RESULTS
RESULTS
Twenty-eight colorectal, four liposarcomas, and one gynecological patient were included. There were no safety issues. Navigation was feasible in 31 patients. The mean target registration errors of 4.0 and 6.3 mm were achieved for straight and French position, respectively. In seven of seven patients with a locally advanced rectal tumor and in seven of eight patients with recurrences, negative margins were achieved. Thirty-three of 36 target lymph nodes were successfully removed. Surgeons using the system indicated faster localization of the tumor and improved decisiveness.
CONCLUSION
CONCLUSIONS
This novel surgical navigation system was safe and feasible during pelvic surgery and can facilitate its users.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
510-517Subventions
Organisme : Maurits en Anna de Kock Stichting
Organisme : KWF Kankerbestrijding
ID : NKI 2014-6596
Organisme : Breuning ten Cate Fonds
Informations de copyright
© 2018 Wiley Periodicals, Inc.