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1.
Article in Chinese | WPRIM | ID: wpr-1020696

ABSTRACT

With the popularity of low-dose computed tomography(LDCT)in physical examination and the widespread concern of people about lung diseases after COVID-19 outbreak,the detection rate of pulmonary nodules in the population has increased year by year.The clinical cases of early lung cancer and multiple primary lung cancer are increasing,and the necessity of personalized treatment tailored to the diverse detection of pulmonary nodules is highlighted in the diagnosis and treatment process of pulmonary nodules.However,chest CT and traditional bron-choscopy not only have insufficient accuracy in preoperative localization of pulmonary nodules and the diagnosis of benign and malignant pulmonary nodules,but also have significant limitations in the diagnosis and treatment of patients who cannot undergo surgery.The emergence of electromagnetic navigation bronchoscopy(ENB)has greatly solved this problem and further improves the diagnosis and treatment process of pulmonary nodules.ENB is a new technology that relies on electromagnetic positioning technology to locate,biopsy,and minimally invasive treatment of pulmonary nodules through bronchoscopy.In this review,we mainly summarize the application and latest progress of ENB in the diagnosis and treatment of pulmonary nodules.

2.
Article in Chinese | WPRIM | ID: wpr-1021488

ABSTRACT

BACKGROUND:Pulsed electromagnetic field is a non-invasive and non-radiative treatment method.Clinical use of pulsed electromagnetic fields in the treatment of orthopedic diseases has achieved certain results. OBJECTIVE:To review the current clinical application of the pulsed electromagnetic field in the treatment of orthopedic diseases,providing a scientific theoretical basis for the clinical treatment of orthopedic diseases. METHODS:The first author used a computer to search PubMed,CBM,Cochrane Library,CNKI,and WanFang Data for related studies on the pulsed electromagnetic field in the treatment of orthopedic diseases,using the keywords of"pulsed electromagnetic field,orthopedics,osteoarthritis,osteoporosis,bone healing,electromagnetic navigation"in English and Chinese.For the literature related to the same content,recent publications were selected.A total of 69 articles were selected from the search results for review. RESULTS AND CONCLUSION:Pulsed electromagnetic field has a definite curative effect on fracture healing.It can be used in the treatment of osteomyelitis by antibacterial,bactericidal,anti-inflammatory and promoting bone healing,and can inhibit osteoporosis and its progress.In addition,the treatment of early osteoarthritis,femoral head necrosis and postoperative rehabilitation of late joint replacement through various ways can become a treatment for orthopedic diseases.However,the therapeutic mechanism of the pulsed electromagnetic field for a variety of orthopedic diseases is still unclear,and most of the research is still in the primary stage.In the future,it is still necessary to obtain more reliable evidence from high-quality research and clinical trials to provide a more perfect basis for the clinical treatment of orthopedic diseases.

3.
Article in Chinese | WPRIM | ID: wpr-971297

ABSTRACT

Transbronchil biopsy has the characteristic of less trauma and quick recovery compared to percutaneous aspiration biopsy. In order to automate this procedure, it requires the development of a robotic surgical system that combines electromagnetic navigation and flexible endoscope. The robotic surgical system introduced herein consists of flexible endoscope, remote-control handle, electromagnetic navigation and dexterous manipulators. The robotic system supports lung bronchial model segmentation and reconstruction, automatic bronchial path planning, real-time navigation and visual biopsy. In the control of the endoscopic catheter, an elasticity compensation algorithm was proposed to improve the location accuracy of the catheter and operational efficiency. Clinical trials proved that the robotic system had high positioning accuracy, was intuitive to operate, and could improve the biopsy efficiency, shorten the learning time, reduce the burden of surgical operations, and lower radiation exposure and infection rate.


Subject(s)
Catheters , Robotic Surgical Procedures , Endoscopy , Bronchoscopy
4.
Article in Chinese | WPRIM | ID: wpr-971298

ABSTRACT

Due to the need to achieve precise operations during surgery, in order to prevent hand tremors and poor surgical field of view, more and more surgical robots are used in surgical operations combined with navigation technology to meet the requirements for surgical accuracy. Open surgery such as orthopaedics, joint replacement and neurosurgery on the market generally use optical navigation systems to guide robots to achieve precise positioning, but optical navigation systems cannot be used for operations in areas with small surgical space. Therefore, a robotic surgical system based on electromagnetic navigation technology that can be applied to the craniofacial area was proposed. By using this robot, the problems of difficult operation and low precision caused by the narrow craniofacial space can be solved. Key techniques and considerations are studied. The function of the developed prototype is verified through model tests. The test results show that the surgical robot under the electromagnetic navigation technology can achieve precise surgical operations improve the success rate of the doctor's surgery and reduce postoperative complications.


Subject(s)
Humans , Robotics , Robotic Surgical Procedures , Electromagnetic Phenomena , Postoperative Complications
5.
Article in Chinese | WPRIM | ID: wpr-1005095

ABSTRACT

@#Objective    To investigate the clinical efficacy of preoperative location of pulmonary nodules guided by electromagnetic navigation bronchoscopy (ENB). Methods    Patients who received preoperative ENB localization and then underwent surgery from March 2021 to November 2022 in the Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were collected. The clinical efficacy and safety of ENB localization and the related factors that may affect the success of ENB localization were analyzed. Results    Initially 200 patients were included, among whom 17 undergoing preoperative localization and biopsy were excluded and a total of 183 patients and 230 nodules were finally included. There were 62 males and 121 females with a mean age of 49.16±12.50 years. The success rate of navigation was 88.7%, and the success rate of ENB localization was 67.4%. The rate of complications related to ENB localization were 2.7%, and the median localization time was 10 (7, 15) min. Multi-variable analysis showed that factors related to successful localization included distance from localization site (OR=0.27, 95%CI 0.13-0.59, P=0.001), staining material (OR=0.40, 95%CI 0.17-0.95, P=0.038), and staining dose (OR=60.39, 95%CI 2.31-1 578.47, P=0.014). Conclusion     ENB-guided preoperative localization of pulmonary nodules is safe and effective, and the incidence of complications is low, which can be used to effectively assist the diagnosis and treatment of early lung cancer.

6.
Zhongguo fei'ai zazhi (Online) ; Zhongguo fei'ai zazhi (Online);(12): 119-134, 2023.
Article in Chinese | WPRIM | ID: wpr-971187

ABSTRACT

BACKGROUND@#The incidence and mortality of lung cancer have always been at the forefront of malignant tumors. With the development of lung cancer detection techniques, more peripheral pulmonary lesions (PPLs) have been detected. The diagnostic accuracy of procedures for PPLs keeps controversial. This study aims to systematically evaluate the diagnostic value and the safety of electromagnetic navigation bronchoscopy (ENB) in the diagnosis of PPLs.@*METHODS@#The relevant literatures in the diagnostic yield of PPLs by ENB were systematically retrieved from Wanfang Data Knowledge Service Platform, China National Knowledge Infrastructure, Embase, PubMed, Cochrane Library and Web of Science. The software of Stata 16.0, RevMan 5.4 and Meta-disc 1.4 were used to conduct the meta-analysis.@*RESULTS@#A total of 54 literatures with 55 studies were included in our meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of ENB in the diagnosis of PPLs were 0.77 (95%CI: 0.73-0.81), 0.97 (95%CI: 0.93-0.99), 24.27 (95%CI: 10.21-57.67), 0.23 (95%CI: 0.19-0.28) and 104.19 (95%CI: 41.85-259.37), respectively. The area under curve (AUC) was 0.90 (95%CI: 0.87-0.92). Meta-regression and subgroup analyses indicated that the potential heterogeneity resulted from study type, additional localization techniques, sample size, lesion size and type of sedation. The use of additional localization techniques and general anesthesia have improved the diagnostic efficiency of ENB in PPLs. The incidence of adverse reactions and complications associated with ENB was very low.@*CONCLUSIONS@#ENB provides well diagnostic accuracy and safety.


Subject(s)
Humans , Bronchoscopy , Lung Neoplasms , Anesthesia , China , Electromagnetic Phenomena
7.
Chinese Journal of Microsurgery ; (6): 139-146, 2023.
Article in Chinese | WPRIM | ID: wpr-995486

ABSTRACT

Objective:To compair the clinical effect of endoscopic spine surgery with and without assistance of an electromagnetic navigation surgical robot(ENSR) system in the treatment of lumbar disc herniations(LDH).Methods:From March 2021 to December 2021, 73 patients with LDH underwent endoscopic minimally invasive treatment in the Department of Spine Surgery, Limin Hospital of Weihai High District. Thirty-eight patients were treated with endoscopic spine surgery assisted by domestic ENSR system(ENSR group), and 35 patients were treated with endoscopic spine surgery alone(endoscopic group). The patients received follow up regularly by telephone or Wechat. The intraoperative fluoroscopy times, puncture times, upper facet arthroplasty times, operation time, preoperative and postoperative Visual Analogue Scale(VAS), Japanese Orthopaedic Association Scores(JOA), and the MOS item short from health survey(SF-36)were compared between the 2 groups. The early postoperative efficacy was evaluated by modified MacNab criteria at 1 week after surgery. SPSS 26.0 was used to analyse the data. P<0.05 was considered that the difference was statistically significant. Results:The age, gender, body mass index(BMI) and other general data of the 2 groups were basically the same, and there was no statistically significant difference( P>0.05). There was no significant difference in the excellent and good rate of postoperative treatment between ENSR group(97.37%) and endoscopic group(94.29%)( Z=0.90, P>0.05). In terms of operation time, intraoperative fluoroscopy times, puncture times, and plasty times, ENSR group[(67.00±17.00) min, (4±2) times, 1 time, 1 time, respectively] was compared with the endoscopic group[(82.00±16.00] min, (17±6) times, (9±5) times, (5±2) times], and the difference was statistically significant( t=3.87,12.62, 9.87, respectively, P<0.05). There were significant differences in VAS, JOA and SF-36 scores between the 2 groups between before and after surgery( F=106.42, 112.14, 26.88, respectively, P<0.05). There was no significant difference in VAS, JOA and SF-36 scores before and after surgery between the 2 groups( F=0.95, 3.54, 0.97, respectively, P>0.05). Conclusion:The endoscopic spine surgery assisted by the ENSR can achieve satisfactory clinical results and is a safe and effective surgical assistance system. For the endoscopic surgery, assisted by the ENSR has obvious advantages in reducing the times of fluoroscopy, puncture, and facet arthroplasty, and shortening the operation time.

8.
Acta Anatomica Sinica ; (6): 560-566, 2023.
Article in Chinese | WPRIM | ID: wpr-1015177

ABSTRACT

Objective Electromagnetic navigation was used to observe and measure important anatomical structures through endoscopic endoscopic approach (EEA) to the ventral skull base to provide data for clinical surgery. Methods Using electromagnetic navigation to measure the anatomical structure of the central and paracentral ventral skull base on 10 fresh cadavers, the internal carotid artery (ICA) was the most important. Results Electromagnetic navigation helped to determine the course of important neurovascular. The ICA of the ventral skull base was divided into 5 segments+ 7 major branches, and the length and course of each were measured and recorded. Conclusion The identification and protection of ICA is the key to EEA treatment of ventral skull base lesions, and electromagnetic navigation assistance can improve the efficiency and safety of EEA surgery.

9.
Article in Chinese | WPRIM | ID: wpr-907145

ABSTRACT

@#Objective    To compare the effectiveness and safety of electromagnetic navigation-guided localization and CT-guided percutaneous localization for pulmonary nodules. Methods    The literature published from the inception to January 2021 about the comparison between electromagnetic navigation-guided localization and CT-guided percutaneous localization for pulmonary nodules in the PubMed, The Cochrane Library, Web of Science, EMbase, Chinese Wanfang database and CNKI database was searched. RevMan (version 5.4) software was used for meta-analysis. Nonrandomized controlled trials were evaluated using methodological index for nonrandomized studies (MINORS). Results    A total of six retrospective studies (567 patients) were included in this meta-analysis. MINORS scores of all studies were all 17 points and above. There were 317 patients in the CT-guided percutaneous localization group and 250 patients in the electromagnetic navigation-guided localization group. The complication rate of the CT-guided percutaneous localization group was significantly higher than that in the electromagnetic navigation-guided localization group (OR=11.08, 95%CI 3.35 to 36.65, P<0.001). There was no significant difference in the success rate of localization (OR=0.48, 95%CI 0.16 to 1.48, P=0.20), localization time (MD=0.30, 95%CI –6.16 to 6.77, P=0.93) or nodule diameter (MD=–0.07, 95%CI –0.19 to 0.06, P=0.29) between the two groups. Conclusion    Electromagnetic navigation can be used  as an effective preoperative positioning method for pulmonary nodules, which has the advantage of lower complication rate compared with the traditional CT positioning method.

10.
Zhongguo fei'ai zazhi (Online) ; Zhongguo fei'ai zazhi (Online);(12): 118-123, 2022.
Article in Chinese | WPRIM | ID: wpr-928788

ABSTRACT

Lung cancer ranks the first cancer-related morbidity and mortality in China. With the development and penetration of imaging technology, increasing small pulmonary peripheral Nodules (SPPNs) have been detected. However, precise location and diagnosis of SPPNs is still a tough problem for clinical diagnosis and treatment in department of thoracic surgery. With the development of electromagnetic navigation bronchoscopy (ENB), it provides a novel minimally invasive method for the diagnosis and treatment of SPPNs. In this review, we summarized the application and progress of ENB in preoperative positioning, diagnosis, and local treatment, then, discussed the clinical application of ENB in the hybrid operating room.
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Subject(s)
Humans , Bronchoscopy/methods , Electromagnetic Phenomena , Lung Neoplasms/surgery , Multiple Pulmonary Nodules/diagnosis , Thoracic Surgery
11.
Article in Chinese | WPRIM | ID: wpr-912990

ABSTRACT

@#Objective    To investigate the diagnostic value and safety of electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound in peripheral pulmonary nodules. Methods    The clinical imaging, surgical and pathological data of 60 patients with 76 peripheral pulmonary nodules who underwent electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound guided biopsy in the Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from June 2020 to June 2021 were retrospectively analyzed. The diagnosis rate and complications were analyzed and summarized. The 76 pulmonary nodules were divided into a small pulmonary nodules group (10 nodules, diameter≤1 cm) and a pulmonary nodules group (1 cm<diameter≤3 cm, 66 nodules) according to diameter. The two groups were compared in terms of operation and diagnosis rate. Results    Pulmonary nodules diameter was 1.8±0.6 cm, operation time 29.8±8.6 min, navigation 2.9±0.9 times, biopsy 9.5±1.9 pieces. In the 76 pulmonary nodules, 55 were confirmed by pathology, with a total diagnosis rate of 72.4%,  including 32 of malignant lesions and 23 of benign lesions. In the 76 pulmonary nodules, 59 had grade 0 hemorrhage, 17 had grade 1 hemorrhage, and none had grade 2 or more serious hemorrhage. Eight patients developed pneumothorax after surgery, and the degree of lung compression was less than 30%, which was improved after symptomatic treatment with oxygen inhalation. The operation time in the small pulmonary nodules group was significantly longer than that in the pulmonary nodules group, and there was no significant difference in diagnosis rate or complications between the two groups. Conclusion    Electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound is a safe and effective method for the diagnosis of periphery pulmonary nodules, and it also has a high diagnostic rate for small pulmonary nodules (≤1 cm), which is worthy of clinical promotion and application.

12.
Article in Chinese | WPRIM | ID: wpr-913005

ABSTRACT

@#The coming out of electromagnetic navigation bronchoscopy gives exciting solution for diagnosis and even treatment of peripheral pulmonary nodules. It breaks the barriers of traditional bronchoscopy, and gives live visible imaging guidance for operators during biopsy of peripheral pulmonary nodules. The electromagnetic navigation bronchoscopy system can intelligently recognize and reconstruct the bronchial tree of the patients, and generate visible data and virtual guidance for the operators. It can perceive real-time magnetic localization of the signal, so as to precisely guide the navigational or biopsy tools. This review introduced the artificial intelligence configuration of the electromagnetic navigation bronchoscopy system based on the Veran system, and gave some improvement advices based on the defects of the system. In this way, we hope to promote the development and better clinical application of electromagnetic navigation bronchoscopy system.

13.
Article in Chinese | WPRIM | ID: wpr-904717

ABSTRACT

@#Objective    To explore the clinical utility and safety of electromagnetic navigation bronchoscopy (ENB)-guided microwave ablation (MWA) in the patients with inoperable high-risk pulmonary nodules. Methods    Clinical data of patients who were diagnosed with inoperable pulmonary nodules highly suspected as malignant tumors and treated with ENB-guided MWA in Zhongshan Hospital, Fudan University from December 2019 to September 2020 were retrospectively collected and analyzed to evaluate the efficacy and safety of the procedure. There were 6 males and 3 females aged 72.0 (59.5-77.0) years. Results    Totally ENB-guided MWA was performed in 9 patients with 12 lesions. All patients suffered from at least one chronic comorbidity. The inoperable reasons included poor pulmonary function (55.6%), comorbidities of other organs which made the surgery intolerable (33.3%), multiple lesions in different lobes or segments (22.2%), personal wills (22.2%) and advanced in age (11.1%). The median diameter of nodules was 13.5 (9.5-22.0) mm and the median distance from the edge of nodules to pleura was 5.3 (1.8-16.3) mm. Bronchoscope maneuver to the targeted lesions was manipulated according to navigation pathway under visual and X-ray guidance and confirmed with radial ultrasound probe. Rapid on-site evaluation also helped with primary pathological confirmation of biopsy specimen. Among all the lesions, 4 adenocarcinoma, 1 non-small cell lung cancer-not otherwise specified and 2 inflammatory lesions were reported in postoperative pathological diagnosis, while no malignant cells were found in 5 specimens. The ablation success rate was 83.3% (10/12). For the two off-targeted lesions, percutaneous ablations were performed as salvage treatment subsequently. The median hospitalization time was 3.0 (2.0-3.0) days and no short-term complications were reported in these patients. Conclusion    ENB-guided MWA is a safe and effective procedure for patients with high-risk pulmonary nodules when thoracic surgery cannot be tolerated.

14.
Zhongguo fei'ai zazhi (Online) ; Zhongguo fei'ai zazhi (Online);(12): 529-537, 2021.
Article in Chinese | WPRIM | ID: wpr-888596

ABSTRACT

Electromagnetic navigation bronchoscopy (ENB) is a novel type of bronchoscopy based on electromagnetic positioning technique combined with virtual bronchoscopy, three-dimensional computed tomography (CT) imaging and respiratory gating technique, which has been widely applied in clinic practice. In recent years, the domestic electromagnetic navigation system has also been developed rapidly, and its effectiveness and safety in the diagnosis, localization, and treatment of peripheral pulmonary lesions have been initially verified. In order to optimize and standardize the technical specifications of domestic ENB and guide its application in clinical practice, the consensus statement has been organized and written in a collaborative effort by the Professional Committee on Respiratory Equipment Technology of Chinese Medical Equipment Association and the Expert Group on Technical of Domestic Electromagnetic Navigation Bronchoscopy.
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15.
Article in Chinese | WPRIM | ID: wpr-799654

ABSTRACT

To summarize the current application of electromagnetic navigation in orthopedics, summarize its characteristics, and provide a better basis for clinical treatment.The domestic and foreign literatures on the application of electromagnetic navigation in orthopedics were reviewed and summarized.Various navigation systems have been used in various clinical fields.Among them, electromagnetic navigation systems have become more and more widely used in orthopedics, and their status has become increasingly prominent.There are many navigation and positioning technologies, which should be comprehensively selected according to the actual clinical situation.Electromagnetic navigation has relatively obvious advantages and greater development potential, and still needs a lot of clinical research to verify.

16.
Article in Chinese | WPRIM | ID: wpr-823433

ABSTRACT

@#Increasing peripheral pulmonary nodules are detected given the growing adoption of chest CT screening for lung cancer. The invention of electromagnetic navigation bronchoscope provides a new diagnosis and treatment method for pulmonary nodules, which has been demonstrated to be feasible and safe, and the technique of microwave ablation through bronchus is gradually maturing. The one-stop diagnosis and treatment of pulmonary nodules can be completed by the combination of electromagnetic navigation bronchoscopy and microwave ablation, which will help achieve local treatment through the natural cavity without trace.

17.
Article in Chinese | WPRIM | ID: wpr-824171

ABSTRACT

To summarize the current application of electromagnetic navigation in orthopedics ,summarize its characteristics,and provide a better basis for clinical treatment.The domestic and foreign literatures on the application of electromagnetic navigation in orthopedics were reviewed and summarized.Various navigation systems have been used in various clinical fields.Among them,electromagnetic navigation systems have become more and more widely used in orthopedics ,and their status has become increasingly prominent.There are many navigation and positioning technologies,which should be comprehensively selected according to the actual clinical situation .Electromagnetic navigation has relatively obvious advantages and greater development potential ,and still needs a lot of clinical research to verify.

18.
Zhongguo fei'ai zazhi (Online) ; Zhongguo fei'ai zazhi (Online);(12): 446-450, 2020.
Article in Chinese | WPRIM | ID: wpr-826956

ABSTRACT

BACKGROUND@#Electromagnetic navigation bronchoscopy is a tool that can accurately navigation peripheral lung lesions. Because of electromagnetic navigation bronchoscopy (ENB) is too expensive, it has not been widely used in China. It is urgent for us to summarize experience in clinical application, especially in the diagnosis of pulmonary nodules.@*METHODS@#The clinical data of patients with pulmonary peripheral lesions (PPLs) in our department undergoing ENB biopsy between July 2017 and December 2018 were retrospectively analyzed.@*RESULTS@#There were 18 patients with 21 PPLs (10 males and 8 females). Among them, 11 patients got the final pathological diagnosis, 8 cases were diagnosed with adenocarcinoma lung cancer, 1 case was diagnosed with tuberculosis and 2 cases were diagnosed with small cell lung cancer. The positive rate of diagnosis was 61.1%. The sensitivity was 73.3%. The positive diagnosis rate is related to the size of the lesion, the positive diagnosis rate for lesions >2 cm is 100.0% (P=0.04).@*CONCLUSIONS@#Electromagnetic navigation bronchoscope is safe and effective in clinic. It has a high positive rate for the diagnosis of peripheral lung lesions larger than 2 cm, ENB has broad clinical application prospects.

19.
Zhongguo fei'ai zazhi (Online) ; Zhongguo fei'ai zazhi (Online);(12): 440-445, 2020.
Article in Chinese | WPRIM | ID: wpr-826957

ABSTRACT

The incidence of peripheral pulmonary lesions (PPLs) is growing following the adoption of lung cancer screening by low-dose chest CT. The diagnosis and treatment of pulmonary nodules is one of the most difficult problems. Based on the electromagnetic positioning technology, the electromagnetic navigation bronchoscope is guided to the pulmonary nodules for biopsy or treatment, providing a new minimally invasive diagnosis and treatment method for suspicious lung lesions. This paper provides an overview of the current status and progress of electromagnetic navigation bronchoscopy in the diagnosis and treatment of peripheral pulmonary diseases.

20.
Article in Chinese | WPRIM | ID: wpr-843097

ABSTRACT

Objective: To evaluate the clinical value of the electromagnetic navigation system for precutaneous transthoracic needle biopsy. Methods: A prospective randomized controlled trial was carried out. One hundred and thirteen patients who needed to have lung nodule biopsy were divided into two groups according to the random number table: the auxiliary puncture group (n=57) adopting the electromagnetic navigation system for precutaneous transthoracic needle biopsy, and the conventional operation group (n=56) adopting the traditional CT-guided transthoracic needle biopsy. The operation process of the two groups was completed by junior doctors under the supervision and guidance of senior doctors. The time of puncture, the number of CT scan, and postoperative complications were observed and compared between the two groups. Results: There was no significant difference in operation time between the auxiliary group and the conventional group [(26.7±8.0) min vs (25.0±7.8) min, P=0.261)]. There was no significant difference in the number of CT scan between the two groups (4.9±2.7 vs 5.1±2.7, P=0.810). There was no significant difference in the incidence rate of pneumothorax (15.8% vs 19.6%, P=0.592) and bleeding (17.5% vs 14.3%, P=0.636) between the two groups. Conclusion: The domestic elec-tromagnetic navigation system for precutaneous transthoracic needle biopsy can safely and effectively assist clinicians to complete lung biopsy.

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