Kuwata Taiji, Shinohara Shuichi, Matsumiya Hiroki, Takenaka Masaru, Oka Soichi, Chikaishi Yasuhiro, Hirai Ayako, Imanishi Naoko, Kuroda Koji, Tanaka Fumihiro
Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
J Thorac Dis. 2018 Mar;10(3):1842-1849. doi: 10.21037/jtd.2018.03.12.
The detection of extremely small lung tumors has increased with the development of computed tomography. Resection of such tumors by thoracoscopy is often hindered due to the unclear location of the tumor. Various methods of preoperative determination of such lesions have been attempted, but without marked success. Here we used virtual-assisted lung mapping (VAL-MAP) to perform surgical resection of small lung lesions.
We selected patients with pulmonary tumors that we anticipated to be difficult to identify during thoracoscopy and/or decide the resection line for sub-lobar lung resection. The wedge resections in the VAL-MAP group were compared to a group of patients who underwent wedge resection without VAL-MAP in 2013.
Surgery duration was significantly shorter in the VAL-MAP group (average: 76.4 min) than in the 2013 group (average: 108.6 min; P=0.000451), although the VAL-MAP group (average major axis: 9.6 mm) had smaller tumors (P=0.000032) and more pure ground-glass opacities (GGOs) (P=0.0000919) than the 2013 group (average major axis: 16.6 mm).
The findings of this study indicate that VAL-MAP is efficacious. In particular, VAL-MAP resulted in a shorter surgery duration and has expanded the indications of resectable lesions.
随着计算机断层扫描技术的发展，极小肺肿瘤的检出率有所增加。由于肿瘤位置不明确，通过胸腔镜切除此类肿瘤常常受到阻碍。人们尝试了多种术前确定此类病变的方法，但均未取得显著成功。在此，我们使用虚拟辅助肺绘图（VAL-MAP）来进行小肺病变的手术切除。
我们选择了预计在胸腔镜检查期间难以识别和/或难以确定亚肺叶肺切除切除线的肺肿瘤患者。将VAL-MAP组的楔形切除术与2013年一组未进行VAL-MAP的楔形切除术患者进行比较。
VAL-MAP组的手术时间（平均：76.4分钟）明显短于2013年组（平均：108.6分钟；P = 0.000451），尽管VAL-MAP组（平均长轴：9.6毫米）的肿瘤比2013年组（平均长轴：16.6毫米）更小（P = 0.000032）且纯磨玻璃影（GGO）更多（P = 0.0000919）。
本研究结果表明VAL-MAP是有效的。特别是，VAL-MAP缩短了手术时间，并扩大了可切除病变的适应症。
