Jiang Tian, Lin Miao, Zhao Mengnan, Zhan Cheng, Li Ming, Feng Mingxiang, Wang Qun
Department of Thoracic Surgery, Zhongshan Hospital Fudan University, Shanghai, China.
Thorac Cardiovasc Surg. 2020 Sep;68(6):525-532. doi: 10.1055/s-0039-3400999. Epub 2020 Mar 1.
This study was aimed to describe a new localization technique developed using medical glue and methylene blue dye, and characterized the localization results and postoperative outcome to evaluate its safety and usefulness.
This retrospective study was conducted at our center from January 2016 to April 2018. Totally 346 consecutive patients with 383 nodules who underwent preoperative computed tomography (CT)-guided medical glue and methylene blue dye localization, followed by lung resection, were enrolled in this study.
Mean nodule size was 7.7 ± 3.7 mm (range: 2-30 mm), with a mean depth from pleura or fissure of 9.4 ± 9.3 mm (range: 0-60 mm). The success rate of CT-guided localization for pulmonary nodules was 99.5% (381/383) of the nodules. Localization-related complications included mild pneumothorax in 16 (4.6%) patients, mild hemothorax in 7 (2.0%) patients, and hemoptysis in 1 (0.3%) patient. Pleural reaction occurred in 7 (2.0%) and pain in 25 (7.2%) patients. All 383 nodules were resected successfully, with conversion to thoracotomy only required in two patients for adhesion and calcification of lymph nodes. All patients recovered well postoperatively, with a short postoperative hospital stay (3.7 ± 2.0 days) and a low complication rate (2.6%, 9/346).
CT-guided medical glue and methylene blue dye localization prior to video-assisted thoracoscopic surgery (VATS) lung resection was a novel, safe, and technically feasible method, with a high-technical success rate and a low-complication rate. It allowed surgeons to easily locate and detect the nodules and estimate the surgical margin.
本研究旨在描述一种使用医用胶水和亚甲蓝染料开发的新定位技术，并对定位结果和术后结局进行特征分析，以评估其安全性和实用性。
本回顾性研究于2016年1月至2018年4月在我们中心进行。共有346例连续患者的383个结节接受了术前计算机断层扫描（CT）引导下的医用胶水和亚甲蓝染料定位，随后进行肺切除术，并纳入本研究。
结节平均大小为7.7±3.7毫米（范围：2 - 30毫米），距胸膜或肺裂的平均深度为9.4±9.3毫米（范围：0 - 60毫米）。肺结节CT引导定位的成功率为99.5%（381/383）。定位相关并发症包括16例（4.6%）患者发生轻度气胸，7例（2.0%）患者发生轻度血胸，1例（0.3%）患者发生咯血。7例（2.0%）患者出现胸膜反应，25例（7.2%）患者出现疼痛。所有383个结节均成功切除，仅2例患者因淋巴结粘连和钙化需要转为开胸手术。所有患者术后恢复良好，术后住院时间短（3.7±2.0天），并发症发生率低（2.6%，9/346）。
在电视辅助胸腔镜手术（VATS）肺切除术前进行CT引导下的医用胶水和亚甲蓝染料定位是一种新颖、安全且技术可行的方法，技术成功率高，并发症发生率低。它使外科医生能够轻松定位和检测结节，并估计手术切缘。
