Sato Masaaki, Aoyama Akihiro, Yamada Tetsu, Menjyu Toshi, Chen Fengshi, Sato Toshihiko, Sonobe Makoto, Omasa Mitsugu, Date Hiroshi
Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan
Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan.
Asian Cardiovasc Thorac Ann. 2015 Jan;23(1):46-54. doi: 10.1177/0218492314539332. Epub 2014 Jun 12.
Virtual-assisted lung mapping is a novel bronchoscopic preoperative lung marking technique using virtual images to conduct multiple concurrent lung markings with dye. This study analyzed the indications, mapping design, and outcomes of lung wedge resection using virtual-assisted lung mapping.
From August 2012 to October 2013, 35 patients with 59 lesions were planned to undergo thoracoscopic lung wedge resection aided by virtual-assisted lung mapping. The data related to virtual-assisted lung mapping were prospectively collected, with the exception of the mapping design which was retrospectively analyzed.
Suspected primary lung cancer (21 lesions in 18 patients) and metastatic lung tumors (38 lesions in 17 patients) were treated by thoracoscopic lung wedge resection with the aid of virtual-assisted lung mapping; 50 wedge resections were conducted with 107 markings. Virtual-assisted lung mapping was most frequently designed to place 2 (n = 15 wedge resections) or 3 (n = 17) markings to both identify the tumor(s) and secure a sufficient resection margin. In 7 wedge resections, anatomical landmarks and/or imaginary auxiliary lines functioned as complementary parts of the lung map when bronchial anatomy did not allow for markings at ideal spots. The resection outcomes were satisfactory without clinically evident complications.
Multiple markings of virtual-assisted lung mapping not only enabled tumor identification, but also secured sufficient resection margins. Special techniques using anatomical landmarks and imaginary auxiliary lines were complementary to the lung map when bronchial anatomy did not allow for markings at ideal spots.
虚拟辅助肺定位是一种新型的支气管镜术前肺标记技术，利用虚拟图像通过染料进行多个同时的肺标记。本研究分析了使用虚拟辅助肺定位进行肺楔形切除术的适应证、定位设计及结果。
2012年8月至2013年10月，35例有59个病灶的患者计划在虚拟辅助肺定位辅助下接受胸腔镜肺楔形切除术。前瞻性收集与虚拟辅助肺定位相关的数据，但定位设计进行回顾性分析。
18例患者的21个病灶为疑似原发性肺癌，17例患者的38个病灶为肺转移瘤，均在虚拟辅助肺定位辅助下接受胸腔镜肺楔形切除术；共进行了50次楔形切除术，标记107次。虚拟辅助肺定位最常设计为放置2个（n = 15次楔形切除术）或3个（n = 17次）标记，以同时识别肿瘤并确保足够的切除边缘。在7次楔形切除术中，当支气管解剖结构不允许在理想位置进行标记时，解剖标志和/或假想辅助线作为肺地图的补充部分发挥作用。切除结果令人满意，无明显临床并发症。
虚拟辅助肺定位的多个标记不仅能够识别肿瘤，还能确保足够的切除边缘。当支气管解剖结构不允许在理想位置进行标记时，使用解剖标志和假想辅助线的特殊技术可作为肺地图的补充。
