Improved Thoracoscopic-Assisted Surgery for the Treatment of Metastatic Thoracic Vertebral Tumors

Summary

Here, we present a protocol to demonstrate an improved thoracoscopic-assisted surgery for the treatment of metastatic thoracic vertebral tumors.

Abstract

The significant progress made in the diagnosis and treatment of malignant tumors has led to improved patient survival rates. However, the metastatic spread of these tumors to the thoracic vertebrae remains a significant challenge, often resulting in bone-related adverse events, such as pathological fractures and severe complications. To address this issue, a refined multidisciplinary approach has been explored, which utilizes thoracoscopic techniques for tumor resection and spinal interventions. Thoracoscopic techniques offer a minimally invasive alternative to traditional open surgical methods, aiming to reduce the overall trauma experienced by patients. By leveraging the advantages of thoracoscopy, clinicians can effectively resect metastatic tumors within the thoracic vertebrae while minimizing the impact on surrounding tissues and structures. This approach, combined with targeted spinal interventions, has the potential to improve patient outcomes and quality of life by mitigating the debilitating effects of pathological fractures and other complications associated with metastatic bone disease. The implementation of this multidisciplinary strategy, incorporating thoracoscopic tumor resection and spinal interventions, represents a promising avenue for the management of metastatic tumors within the thoracic vertebrae. Further research and clinical evaluation are necessary to fully elucidate the long-term benefits and establish the optimal treatment protocols for this patient population, ultimately enhancing the care and outcomes for individuals afflicted by this challenging condition.

Introduction

As advances in the diagnosis and treatment of malignant tumors continue, the survival rates of patients with malignancies have significantly increased¹. However, a concomitant rise in the incidence of bone-related adverse events caused by malignant tumors, particularly metastases to the thoracic vertebrae, has been observed². Many patients with widespread bone metastases, especially those with thoracic vertebral involvement, experience pathological fractures leading to severe pain and even paralysis³.

Open procedures require large skin incisions and extensive muscle di....

Protocol

Written informed consent was obtained from the patients for publication. This surgical protocol adheres to the ethical standards established bythe Ethics Committee of The First Affiliated Hospital, Zhejiang University School of Medicine (Grant number: IIT20240869A).

1. Preoperative assessment

1. Use the following inclusion criteria: Participants aged 18 years and older; confirmed diagnosis of metastatic thoracic vertebral tumors using imaging (MRI, CT scans) and biops.......

Discussion

The disadvantages of open surgery include larger incisions and longer scars, leading to more extensive tissue disruption and greater postoperative pain¹³. This approach often results in higher blood loss during the procedure and increases the risk of infection and complications due to broader exposure. Patients experience longer recovery times, extended hospital stays, and delayed return to normal activities. Additionally, open surgery has a greater impact on lung function, increasing the risk of .......

Materials

Name	Company	Catalog Number	Comments
Absorbable sutures	ETHICON	VCP739D	Johnson & Johnson 2-0 Absorbable Suture for suturing incisions
anesthesia drug	Anlibang Pharmaceuticals	propofol injectable emulsion	Sedation used in anesthesia procedures
anterior fixation system	Medtronic	VANTAGE	Medtronic's Vertebral Lateral Fixation System can be used to fixate the adjacent vertebral bodies to the implanted artificial vertebral body from the lateral side of the vertebrae, creating a stable overall structure.
Artificial vertebral body	Stryker	VLIFT	Stryker Artificial Vertebral Body is used for implanting an artificial vertebral body prosthesis after the removal of a diseased vertebra to support the spine.
C-arm	GE	OEC One CFD	Used for intraoperative fluoroscopic confirmation of the proper positioning of metal implants.
Thoracoscope System	stryker	Precision Ideal Eyes HD	Used for imaging of visceral organs within the thoracic cavity to facilitate the surgical manipulation of pathological structures.
Ultrasonic bone knife	SMTP	XD860A	Used for intraoperative cutting of bone tissue.