Moon Seok Whan, Cho Deog Gon, Cho Kyu Do, Kang Chul Ung, Jo Min Seop, Park Hyun Jin
Department of Thoracic and Cardiovascular Surgery, St. Paul Hospital, The Catholic University of Korea, Jeonong-dong Dongdaemoon-gu, Seoul, South Korea.
Thorac Cardiovasc Surg. 2012 Sep;60(6):413-8. doi: 10.1055/s-0031-1299582. Epub 2012 Mar 1.
Preoperative localization is frequently necessary to perform thoracoscopic resection of a small and/or deeply located intrapulmonary lesion. We developed a new method that uses a fragmented platinum microcoil, and retrospectively evaluated the efficacy of our technique.
Between January 2006 and May 2010, self-made microcoils (Easimarker) were used to localize total 32 lesions (21 solid nodules, and 11 ground glass opacities) in 30 patients. Computed tomography-guided localization was performed into, or just around the lesions. Localized lesions were resected using fluoroscopy-assisted thoracoscopic surgery (FATS), and the histopathologic diagnosis was confirmed. The accuracy and complications of the localization procedure, and operative results of FATS were observed.
Mean size and depth of all lesions were 11.8 ± 5.1 mm (range: 3 to 22) and 12.2 ± 7.1 mm (range: 2 to 30). CT-guided localizations were successfully performed in all lesions. Four minimal pneumothorax and one parenchymal hematoma related with localization procedure occurred. There were three repeated procedures, which resulted from pleural rebounding of the microcoils. There were two microcoil detecting failures due to intrathoracic displacement during FATS. All 32 resected lesions were histopathologically diagnosed.
CT-guided localization using the fragmented microcoil combined with FATS of small intrapulmonary lesions is a safe, effective, and a diagnostically accurate procedure.
对于小型和/或位于肺深部的肺内病变进行胸腔镜切除时，术前定位常常是必要的。我们开发了一种使用分段铂微线圈的新方法，并对我们技术的有效性进行了回顾性评估。
在2006年1月至2010年5月期间，使用自制的微线圈（Easimarker）对30例患者的总共32个病变（21个实性结节和11个磨玻璃影）进行定位。在病变内部或其周围进行计算机断层扫描引导下的定位。使用荧光透视辅助胸腔镜手术（FATS）切除定位的病变，并确认组织病理学诊断。观察定位过程的准确性和并发症以及FATS的手术结果。
所有病变的平均大小和深度分别为11.8±5.1毫米（范围：3至22毫米）和12.2±7.1毫米（范围：2至30毫米）。所有病变均成功进行了CT引导下的定位。发生了4例与定位过程相关的轻度气胸和1例实质血肿。由于微线圈的胸膜反弹，有3例进行了重复操作。由于FATS期间胸腔内移位，有2例微线圈检测失败。所有32个切除的病变均经组织病理学诊断。
使用分段微线圈结合FATS对小型肺内病变进行CT引导下定位是一种安全、有效且诊断准确的方法。
