Efficacy and safety of artificial pneumothorax with position adjustment for CT-guided percutaneous transthoracic microwave ablation of small subpleural lung tumors

Abstract

Background: To evaluate the efficacy and safety of artificial pneumothorax with position adjustment for computed tomograpy (CT)-guided percutaneous transthoracic microwave ablation (MWA) of small subpleural lung tumors. Methods: Fifty-six patients with small subpleural lung tumors (< 3.0 cm) entered the study and underwent CT-guided MWA with (group I: 24 patients with 24 tumors) or without (group II: 32 patients with 34 tumors) the support of artificial pneumothorax. Follow-up contrast-enhanced CT scans were reviewed. Pain VAS (visual analog scale) scores at, during, and after ablation were compared between the two groups. Technical success, technique efficacy, local tumor control and complications were compared. Results: Creation of the artificial pneumothorax was achieved for 24/24 (100%) in group I and no complication related to the procedure was observed. Technical success of MWA was achieved for all 58 tumors. Primary efficacy of MWA was achieved in 23 of 24 tumors (95.8%) treated in group I, and 32 of 34 tumors (94.1%) treated in group II (P = 0.771). The 12-month local tumor control was achieved in 87.5% (21/24) in group I compared with 88.2% (30/34) in group II (P = 0.833). Pain VAS scores in group I were significantly decreased after the pneumothorax induction at, during, and after ablation compared with group II (P < 0.05). There was no significant difference in MWA-related complications (P > 0.05). Conclusion: Artificial pneumothorax with position adjustment for CT-guided MWA is effective and may be safely applied to small subpleural lung tumors. Artificial pneumothorax is a reliable therapy for pain relief.