Liao Ming, He Zhe, Xu Enwu, Wu Dehua
Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Department of Thoracic Surgery, General Hospital of Southern Theater Command, PLA, Guangzhou 510010, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2020 May 30;40(5):718-722. doi: 10.12122/j.issn.1673-4254.2020.05.17.
To evaluate the value and clinical effect of different preoperative localization techniques for solitary pulmonary nodules (SPN) before single-port thoracoscopic surgery.From January 2018 to June 2019, 54 patients diagnosed with solitary pulmonary nodules received single-port thoracoscopic surgery in Thoracic Department of General Hospital of Southern Theater Command of PLA. Based on the location methods of the nodules, the patients were divided into group A (34 cases) with preoperative CT-guided Hook-wire (a common positioning needle usually using in mammary gland) positioning and group B (20 cases) with preoperative CT-guided methylene blue location.The success rate of localization in group A was 94.18% (32/34), significantly higher than that in group B [85% (17/20), < 0.05). No intraoperative conversion to thoracotomy occurred in group A, while the conversion rate was 10% (2/20) in group B ( < 0.05). The average positioning cost was significantly higher in group A than in group B (1715±109 1021±86 RMB yuan, < 0.05), but the total hospitalization cost was similar between the two groups (50 114±3788 47871±5902 RMB yuan, >0.05). The length of hospital stay was significantly shorter in group A than in group B (6.71±1.23 8.19±2.61 days, < 0.05).Compared with the traditional methylene blue localization method, Hook-wire localization positioning can significantly increase the success rate of localization, and can be used as the standard preoperative localization method in patients undergoing single-port thoracoscopic pulmonary nodule resection, especially in those with deep nodule location from the visceral pleura.
评估单孔胸腔镜手术前不同术前定位技术对孤立性肺结节（SPN）的价值及临床效果。2018年1月至2019年6月，54例诊断为孤立性肺结节的患者在解放军南部战区总医院胸外科接受了单孔胸腔镜手术。根据结节的定位方法，将患者分为A组（34例），采用术前CT引导下Hook-wire（一种常用于乳腺的普通定位针）定位，B组（20例）采用术前CT引导下亚甲蓝定位。A组定位成功率为94.18%（32/34），显著高于B组[85%（17/20），P<0.05]。A组无术中中转开胸情况，而B组中转率为10%（2/20）（P<0.05）。A组平均定位费用显著高于B组（1715±109 vs 1021±86元，P<0.05），但两组总住院费用相似（50114±3788 vs 47871±5902元，P>0.05）。A组住院时间显著短于B组（6.71±1.23 vs 8.19±2.61天，P<0.05）。与传统亚甲蓝定位方法相比，Hook-wire定位可显著提高定位成功率，可作为单孔胸腔镜肺结节切除术患者的标准术前定位方法，尤其是对于距脏层胸膜位置较深的结节患者。
