Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Thorac Cardiovasc Surg. 2012 Apr;143(4):809-14. doi: 10.1016/j.jtcvs.2011.10.038. Epub 2011 Nov 20.
To investigate the factors related to the successful computed tomography-guided nodule localization for subsequent nodule excision.
We retrospectively reviewed the medical records for 181 patients who had undergone computed tomography-guided nodule localization using hook wire and subsequent video-assisted thoracic surgery resection for lung nodules. The demographic factors, nodule factors, and technical factors were reviewed to determine what affects effective nodule localization for video-assisted thoracic surgery resection using both univariate and multivariate models.
A total of 174 patients were included in our study. Successful localization was accomplished in 166 patients (95%). Univariate analysis implicated patient age, nodule solidity, zonal location, and a sufficient distance between the hook wire tip and pleural surface as significant factors for successful localization. Multivariate analysis focused on the distance between the wire tip and pleural surface as the sole independent factor for successful localization (P = .012).
The distance between the hook wire tip and pleural surface was the major significant factor for successful computed tomography-guided nodule localization for subsequent video-assisted thoracic surgery resection. Thus, the localization of a hook wire adjacent to a target nodule with sufficient depth from the pleural surface is crucial to the success of the procedure.
探讨与 CT 引导下结节定位相关的因素，以便后续进行结节切除。
我们回顾性分析了 181 例接受 CT 引导下钩丝定位，随后行电视辅助胸腔镜手术切除肺部结节的患者的病历。回顾了人口统计学因素、结节因素和技术因素，以确定哪些因素会影响使用单变量和多变量模型的电视辅助胸腔镜手术切除的有效结节定位。
共有 174 例患者纳入本研究。166 例（95%）患者成功定位。单因素分析提示患者年龄、结节实性成分、区域位置以及钩丝尖端与胸膜表面之间的足够距离是成功定位的重要因素。多因素分析则集中于钩丝尖端与胸膜表面之间的距离是成功定位的唯一独立因素（P=.012）。
钩丝尖端与胸膜表面之间的距离是 CT 引导下结节定位以进行后续电视辅助胸腔镜手术切除的主要显著因素。因此，将钩丝定位在距胸膜表面足够深度的目标结节旁是该操作成功的关键。
