Davini F, Gonfiotti A, Vaggelli L, De Francisci A, Gigli P, Janni A
Thoracic Surgery Unit, Careggi Hospital, Florence, Italy.
J Cardiovasc Surg (Torino). 2006 Jun;47(3):355-9.
The aim of this study is to compare 2 different methods for localization of peripheral pulmonary lesions requiring thoracoscopic resection: radioguided surgery (still considered an innovative method) and computed tomography-guided hookwire localization.
Thirty randomized patients (21 males and 9 females), ranging from 21-74 years, average age 56.3 years) with solitary pulmonary nodule (SPN) were enrolled in this prospective study. Inclusion criteria was: a maximum nodule diameter of less than 3 cm and a maximum distance from the visceral pleura of 3 cm. The patients were subdivided into 2 equal groups and one of the 2 different methods for diagnosing SPN was applied. Group A received a thoracoscopy using the scinti-probe technique and group B received a thoracoscopy aided by a hooked needle.
The frozen section revealed a primitive pulmonary tumor in 13 cases, intestinal adenocarcinoma metastasis in 3 cases and renal cancer metastasis in 1 case. The remaining 13 cases were pathologically benign: sarcoidosis in 6 cases, hamartochondroma in 3 cases, scleroanthracosis in 2 cases and tuberculoma in 2 cases.
On the basis of our experience, the conclusion is drawn that this methods has been proven efficacious in the diagnosis of SPN, and video-assisted thoracoscopy allows for the removal of pulmonary nodules without complications.
本研究旨在比较两种用于需要胸腔镜切除的周围型肺病变定位的不同方法：放射性引导手术（仍被视为一种创新方法）和计算机断层扫描引导下的钩丝定位。
30例随机患者（21例男性和9例女性，年龄21 - 74岁，平均年龄56.3岁）患有孤立性肺结节（SPN）被纳入这项前瞻性研究。纳入标准为：最大结节直径小于3 cm且距脏层胸膜最大距离为3 cm。患者被分为两组，每组人数相等，并应用两种不同的SPN诊断方法之一。A组采用闪烁探头技术进行胸腔镜检查，B组采用带钩针辅助的胸腔镜检查。
冰冻切片显示13例为原发性肺肿瘤，3例为肠腺癌转移，1例为肾癌转移。其余13例病理结果为良性：结节病6例，错构瘤3例，硬化性炭末沉着症2例，结核瘤2例。
根据我们的经验，得出的结论是，该方法已被证明在SPN诊断中有效，且电视辅助胸腔镜检查可实现肺结节的切除且无并发症。
