Hu Jian, Zhang Chong, Sun Li
Department of Thoracic and Cardiovascular Surgery, First Hospital, College of Medicine, Zhejiang University, Zhejiang, China.
ANZ J Surg. 2006 Jul;76(7):649-51. doi: 10.1111/j.1445-2197.2006.03790.x.
The aim of this study is to discuss and summarize the localization of small pulmonary nodules for video-thoracoscopic surgery. Thirty-eight patients were selected, 22 men and 16 women, and they underwent video-assisted thoracoscopic surgery resection for small pulmonary nodules: 28 patients for small solitary pulmonary nodules and 10 patients for multiple small pulmonary nodules. In all cases, resection of the nodules was successful. Localization methods included: (i) computed tomography (CT)-guided methylene blue labelling for preoperative localization; (ii) a high-quality chest CT scan for preoperative localization; (iii) visual exploration, digital palpation and 'instrumental' palpation to locate the nodule; and (iv) endosonographic inspections of intraoperative localization. Using a combination of CT scan, digital palpation, methylene blue labelling and endosonographic inspections, all nodules were successfully localized and resected without significant complications. Video-assisted thoracoscopic surgery is an effective approach but the small lung nodules (especially those less than 1.0 cm in diameter) localized at thoracoscopic resection must be treated carefully. Combined imaging and thoracoscopic techniques may help identify small nodules.
本研究旨在探讨和总结电视胸腔镜手术中小肺结节的定位方法。选取38例患者，其中男性22例，女性16例，均接受电视胸腔镜手术切除小肺结节：28例为孤立性小肺结节，10例为多发性小肺结节。所有病例中，结节切除均获成功。定位方法包括：（i）术前CT引导下亚甲蓝标记定位；（ii）高质量胸部CT扫描术前定位；（iii）视觉探查、数字触诊和“器械”触诊定位结节；（iv）术中超声内镜检查定位。通过CT扫描、数字触诊、亚甲蓝标记和超声内镜检查相结合，所有结节均成功定位并切除，无明显并发症。电视胸腔镜手术是一种有效的方法，但胸腔镜切除时定位的小肺结节（尤其是直径小于1.0 cm者）必须谨慎处理。联合影像学和胸腔镜技术有助于识别小结节。
