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电视辅助胸腔镜手术中肺结节的超声定位用于精准亚肺叶切除术。

Ultrasound location of pulmonary nodules in video-assisted thoracoscopic surgery for precise sublobectomy.

机构信息

Department of Thoracic Surgery, Tianjin Third Central Hospital, Tianjin, China.

Tianjin Institute of Hepatobiliary Disease, Tianjin, China.

出版信息

Thorac Cancer. 2020 May;11(5):1354-1360. doi: 10.1111/1759-7714.13384. Epub 2020 Mar 17.

Abstract

BACKGROUND

We investigated the clinical value of accurate sublobectomy of pulmonary nodules using video-assisted thoracoscopy (VATS). In June 2017 to June 2019, single lung nodule patients who accepted thoracoscopic resection were included. Palpation and intraoperative ultrasound (IU) were used to localize lung nodules, and the success rate, location time and safety compared. Performance of lung nodule ultrasound was assessed. The success rate of IU localization of pulmonary nodules with different properties was studied.

RESULTS

A total of 33 cases with single pulmonary nodules were included in the study, and 32 cases (97%) were successfully located by IU as opposed to 16 cases (48.5%) located by palpation (P < 0.05). Clear hypoechoic ultrasound images of nodules were obtained in all 32 cases, and the diameter of pulmonary nodules on ultrasound and CT were found to have a significant correlation (R = 0.860, P = 0.000). The average positioning time of IU was lower than that of the palpation group (P < 0.05). No complications occurred during ultrasound examination. The success rate of intraoperative ultrasonic localization between the pure ground-glass opacity (p-GGO) group and the mixed-ground-glass opacity (m-GGO) group was 90%, 100% (P = 0.526).

CONCLUSIONS

In thoracoscopic surgery, IU can locate pulmonary nodules accurately, efficiently and safely, and also has a high degree of accuracy in locating different types of pulmonary nodules.

摘要

背景

我们研究了使用电视辅助胸腔镜(VATS)进行肺部小结节精准亚肺叶切除术的临床价值。2017 年 6 月至 2019 年 6 月,纳入接受胸腔镜切除术的单肺结节患者。触诊和术中超声(IU)用于定位肺结节,并比较了成功率、定位时间和安全性。评估了肺部结节超声的性能。研究了不同性质的肺部结节 IU 定位的成功率。

结果

共纳入 33 例单肺结节患者,IU 成功定位 32 例(97%),而触诊定位 16 例(48.5%)(P<0.05)。所有 32 例均获得清晰的结节低回声超声图像,且超声和 CT 上的肺结节直径具有显著相关性(R=0.860,P=0.000)。IU 的平均定位时间低于触诊组(P<0.05)。超声检查过程中未发生并发症。纯磨玻璃密度(p-GGO)组和混合磨玻璃密度(m-GGO)组的术中超声定位成功率分别为 90%和 100%(P=0.526)。

结论

在胸腔镜手术中,IU 可以准确、高效、安全地定位肺结节,对不同类型的肺结节定位也具有高度准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/7180562/61128b8702a8/TCA-11-1354-g001.jpg

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