Sui Xizhao, Zhao Hui, Yang Feng, Liu Ganwei, Hu Libao, Chen Chen, Gao Jian, Wang Jun
Department of Thoracic Surgery, Center for Mini-invasive Thoracic Surgery, People's Hospital, Peking University, Beijing, China.
Department of Radiology, People's Hospital, Peking University, Beijing, China.
J Surg Res. 2018 Apr;224:193-199. doi: 10.1016/j.jss.2017.12.020. Epub 2018 Jan 5.
This study aimed to investigate the factors affecting successful microcoil localization for subsequent thoracoscopic resection of pulmonary small nodules and ground-glass nodules. Microcoil has been useful for preoperative localization. Nevertheless, microcoil may dislocate before video-assisted thoracoscopic surgery.
The medical data of patients with pulmonary solid nodules and ground-glass nodules, who underwent computed tomography-guided microcoil localization before thoracoscopic surgery, were retrospectively reviewed. Factors including clinical data, imaging data, surgical data, and technical data of microcoil localization were collected for stepwise logistic regression analysis.
A total of 206 nodules in 192 patients were included in this study. Microcoil dislocation was identified on video-assisted thoracoscopic surgery exploration in six patients (2.9%), resulting in a successful localization rate of 97.1%. The insertion depth of Chiba needle, transfissure needle tract, and pneumothorax after localization were implicated as significant factors for successful microcoil localization. Based on logistic regression, the insertion depth of Chiba needle and pneumothorax after localization were identified as the independent factors for successful microcoil localization.
The insertion depth of Chiba needle and pneumothorax after localization were the independent factors affecting successful microcoil localization for subsequent thoracoscopic resection. Special care should be taken in terms of the sufficient insertion depth of Chiba needle during microcoil localization and the risk of dislocation.
本研究旨在探讨影响肺小结节及磨玻璃结节胸腔镜切除术中微线圈定位成功的因素。微线圈在术前定位中很有用。然而，微线圈在电视辅助胸腔镜手术前可能会移位。
回顾性分析胸腔镜手术前行计算机断层扫描引导下微线圈定位的肺实性结节及磨玻璃结节患者的医学资料。收集微线圈定位的临床资料、影像资料、手术资料及技术资料等因素进行逐步逻辑回归分析。
本研究共纳入了192例患者的206个结节。6例患者（2.9%）在电视辅助胸腔镜手术探查中发现微线圈移位，成功定位率为97.1%。千叶针穿刺深度、经叶间裂针道及定位后气胸被认为是微线圈定位成功的重要因素。基于逻辑回归分析，千叶针穿刺深度及定位后气胸被确定为微线圈定位成功的独立因素。
千叶针穿刺深度及定位后气胸是影响后续胸腔镜切除术中微线圈定位成功的独立因素。微线圈定位时应特别注意千叶针的足够穿刺深度及移位风险。
