CT 引导下经皮肺小结节术前彩色标记在电视辅助胸腔镜手术中的应用。

CT-guided color marking of impalpable pulmonary nodules prior to video-assisted thoracoscopic surgery.

机构信息

Department of Radiology, Shimane University, Faculty of Medicine, Japan.

出版信息

Clin Imaging. 2021 Jun;74:84-88. doi: 10.1016/j.clinimag.2021.01.003. Epub 2021 Jan 12.

DOI:10.1016/j.clinimag.2021.01.003

PMID:33454581

Abstract

OBJECTIVES

To investigate the utility and complications of computed tomography (CT)-guided color marking of impalpable pulmonary nodules for video-assisted thoracoscopic surgical resection.

METHODS

This retrospective single institutional study has obtained Institutional Review Board approval. A total of 174 patients with 207 undiagnosed peripheral lesions of the lung were enrolled who had undergone preoperative computed tomography-guided color marking using colored collagen followed by video-assisted thoracoscopic surgery (VATS) from December 2015 to September 2018.

RESULTS

All nodules (mean 14.0 mm, range 3.0-30.0 mm) were successfully marked by computed tomography-guided color marking, and 96.0% cases (167/174) were localized by means of intraoperative fluoroscopy as clear spots. Minor pneumothorax with a median volume of 3.8 mL (range 0.2-119.0 mL) occurred in 12 patients (6.9%) who were completely asymptomatic and were not in serious condition. No patient required a chest tube. No major bleeding complication occurred, and no air emboli were seen. No intra- or post-operative mortality of VATS was observed.

CONCLUSIONS

Preoperative CT-guided color marking of impalpable pulmonary nodules is a safe and effective procedure that allows for successful surgical resection.

摘要

目的

探讨 CT 引导下对不可触及性肺结节进行彩色标记在电视辅助胸腔镜手术（VATS）切除中的应用价值及并发症。

方法

这是一项回顾性的单中心研究，已获得机构审查委员会的批准。共纳入 2015 年 12 月至 2018 年 9 月期间因术前 CT 引导下彩色胶原标记辅助 VATS 治疗的 174 例 207 个不明原因的外周肺部病变患者。

结果

所有结节（平均 14.0mm，范围 3.0-30.0mm）均成功地通过 CT 引导下的彩色标记进行了标记，96.0%（167/174）的病例通过术中荧光透视显示为清晰的斑点进行了准确定位。12 例（6.9%）患者出现中等量气胸，中位数为 3.8ml（范围 0.2-119.0ml），患者完全无症状，病情不严重。无患者需要放置胸腔引流管。无严重出血并发症，未见空气栓塞。VATS 无术中或术后死亡。