Department of Thoracic Surgery, The Second Hospital of Shandong University, Jinan, 250000, People's Republic of China.
Department of Radiation Oncology, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China.
Sci Rep. 2020 Dec 8;10(1):21459. doi: 10.1038/s41598-020-78146-z.
The resection of nodules by thoracoscopic surgery is difficult because the nodules may be hard to identify. Preoperative localization of pulmonary nodules is widely used in the clinic. In this study, we retrospectively compared CT-guided hook wire localization and electromagnetic navigation bronchoscopy (ENB) localization of small pulmonary nodules before resection. Patients who underwent localization with CT-guided hook wire or ENB followed by video-assisted thoracoscopic surgery (VATS) at Qilu Hospital of Shandong University between January 2016 and December 2019 were retrospectively included. Clinical parameters, complication and failure rate, and localization time were compared between two groups. A total of 157 patients underwent the localization procedure successfully. Pulmonary nodules were localized by CT-guided hook wire in 105 patients and by ENB in 52 patients. The nodule size in ENB group was smaller than that in CT-guided localization group (P < 0.001). Both CT-guided localization and ENB localization were well tolerated in all patients, while ENB localization leaded to less complications (P = 0.0058). In CT-guided localization group, 6 patients failed to be located while none failed in ENB group (P = 0.079). The procedure time was 15.15 ± 3.70 min for CT-guided localization and 21.29 ± 4.00 min for ENB localization (P < 0.001). CT-guided localization is simple and feasible for uncertain pulmonary nodules before surgery. ENB localization could identify small lung nodules with high accuracy and achieve lower incidence of complications.
胸腔镜手术切除结节较为困难，因为结节可能难以识别。术前对肺结节进行定位在临床上得到了广泛应用。本研究回顾性比较了 CT 引导下钩丝定位和电磁导航支气管镜（ENB）定位在切除前对小肺结节的作用。纳入 2016 年 1 月至 2019 年 12 月期间在山东大学齐鲁医院行定位后行电视辅助胸腔镜手术（VATS）的 CT 引导下钩丝或 ENB 定位患者。比较两组的临床参数、并发症和失败率以及定位时间。共 157 例患者成功完成了定位操作。105 例患者行 CT 引导下钩丝定位，52 例患者行 ENB 定位。ENB 组的结节大小小于 CT 引导定位组（P<0.001）。两组患者均能耐受 CT 引导定位和 ENB 定位，而 ENB 定位导致的并发症更少（P=0.0058）。在 CT 引导定位组，有 6 例患者未能定位，而 ENB 组无患者失败（P=0.079）。CT 引导定位的操作时间为 15.15±3.70 min，ENB 定位的操作时间为 21.29±4.00 min（P<0.001）。CT 引导定位对于术前不确定的肺结节简单可行。ENB 定位可准确识别小结节，并发症发生率较低。
