Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan.
Ann Thorac Surg. 2018 Dec;106(6):1661-1667. doi: 10.1016/j.athoracsur.2018.07.030. Epub 2018 Sep 12.
Preoperative computed tomography (CT)-guided dye localization is essential for the surgical treatment of small lung nodules and is mostly performed by radiologists in the CT room. Several studies reported their early experiences of preoperative localization in the hybrid operating room. A comparison between localization in the CT room and hybrid room has not been reported. Therefore, we compared the outcomes of preoperative localization in the hybrid and CT rooms.
This study included patients who underwent preoperative CT-guided dye localization for thoracoscopic lung tumor surgery in the hybrid operation room (n = 25) and CT room (n = 283) at our institute. Propensity matched analysis, incorporating nodule size, number, and depth, and operation method, was used to compare the short-term outcomes of these two groups. Each patient in the hybrid room group was matched with 2 patients in the CT room group.
Localization was successfully performed in 23 patients (92%) and 50 patients (100%) in the hybrid room and CT room groups, respectively. There was no significant difference in demographics between groups. In the hybrid room group, the global time was shorter (192.6 versus 244.1 minutes, p = 0.003), and the localization time was longer (33.1 versus 22.3 minutes, p < 0.001). All lung nodules were successfully resected in both groups, but the hybrid room group had a relatively higher morbidity rate.
The hybrid operating room may be associated with a shorter global time and similar perioperative and postoperative outcomes compared with the CT room. Localization in the hybrid operating room seems an effective alternative method for managing small lung nodules.
术前 CT 引导染料定位对于小肺结节的外科治疗至关重要，通常由 CT 室的放射科医生进行。有几项研究报告了他们在杂交手术室进行术前定位的早期经验。尚未报道 CT 室和杂交手术室之间的定位比较。因此，我们比较了杂交手术室和 CT 室术前定位的结果。
本研究包括在我院杂交手术室（n=25）和 CT 室（n=283）接受术前 CT 引导染料定位行胸腔镜肺肿瘤手术的患者。采用纳入结节大小、数量和深度以及手术方法的倾向评分匹配分析来比较两组的短期结果。杂交手术室组的每位患者与 CT 室组的 2 位患者匹配。
在杂交手术室组和 CT 室组，分别有 23 例（92%）和 50 例（100%）患者成功定位。两组间的人口统计学数据无显著差异。在杂交手术室组，总时间更短（192.6 分钟 vs. 244.1 分钟，p=0.003），定位时间更长（33.1 分钟 vs. 22.3 分钟，p<0.001）。两组均成功切除所有肺结节，但杂交手术室组的发病率相对较高。
与 CT 室相比，杂交手术室可能与更短的总时间以及相似的围手术期和术后结果相关。杂交手术室中的定位似乎是管理小肺结节的一种有效替代方法。
