Abstract: Objective To investigate the safety and feasibility of the combination of video-assisted thoracoscopic surgery(VATS) and electromagnetic navigation bronchoscopy(ENB)-guided microwave ablation(MWA) for synchronous multiple primary lung cancer(sMPLC).
Methods To retrospectively analyzed the clinical data of 13 patients with sMPLC in our hospital during the period from March 2017 to September 2020,who received VATS combined with ENB-guided MWA.
Results A total of 44 lesions were in 13 patients with sMPLC.Surgical resection was performed in 31 lesions,and ENB-guided MWA was performed in 13 lesions.Segmentectomy was the main surgical method,accounting for 46.2%.The mean size of main resected lesions was(22.2±12.8)mm.The mean size of lesions ablated by microwave was(10.2±5.8)mm.Mean drainage of postoperative first day was(177.7±93.3)ml.Mean chest drain duration was(2.8±1.8)d.Mean length of postoperative hospital stay was(3.7±1.8)d.Postoperative persistent air leakage for more than 7 days existed in 1 patient.No others complications occurred.The mean follow-up time was(10.6±10.5)months.No recurrence or death occurred up to now.
Conclusion VATS combined with ENB-guided MWA was a safe and feasible option for sMPLC.Accurate pathological staging was obtained by surgery to guide postoperative individualized treatment.Added ENB-guided MWA did not increase the patients' perioperative risk,could reduce the surgical resection scope and protected lung function to the maximum extent.

Key words: multiple primary lung cancer, microwave ablation, electromagnetic navigation bronchoscopy, prognosis