A21-10 Safety and Efficacy of CT Guided Percutaneous Pulmonary Nodule Microwave Ablation Under General Anaesthesia With Endotracheal Intubation: A Retrospective, Two-center, Large Volume Study

Objectives Pulmonary nodule ablation presents several clinical challenges, such as surgical stress and patient discomfort, when performed under local anaesthesia. We aimed to evaluate the safety and efficacy of percutaneous pulmonary nodule ablation under general anaesthesia with endotracheal intubation. Materials and Methods This retrospective study included 405 patients who underwent percutaneous pulmonary nodule ablation under general anaesthesia between 2020 and 2025. The procedural workflow involved a preoperative CT scan, patient positioning, repeat CT scans, ablation needle insertion, and post-operative evaluation. Patients were categorised into pre-drain and pre-clamp groups. Results In total, 405 patients (mean age 57.90 ±13.19 years, 44.9% male) with 550 nodules underwent pulmonary nodule ablation under general anaesthesia (390 nodules in 261 pre-drain and 160 in 144 pre-clamp patients). The groups differed in sex, nodule size, and depth, but not in age, smoking, or cancer history. The median nodule size and depth were 10.00 60.00 mm, respectively. The mean procedure, anaesthesia, and ablation times were approximately 68, 103, and 8-9 min, respectively. Overall complete ablation rate was 95.1% and total complication rate was 15.1% (61/405), including pneumothorax (n = 25), pleural effusion (n = 7), chest pain (n = 14), haemothorax (n = 3), haemoptysis (n = 10), dry cough (n = 14), post-ablation fever (n = 12), missed ablation (n = 3), empyema (n = 1), and haemorrhage (n = 1). Conclusion Percutaneous pulmonary nodule microwave ablation under general anaesthesia is safe and feasible, while enabling patient comfort, precise ventilation control, and needle positioning. This approach allows for tailored treatment strategies using advanced imaging, thereby expanding treatment possibilities for pulmonary nodule ablation.