Zhou Chao, Li Xinming, Li Wentao, Qian Jun
Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
Department of Cardiothoracic Surgery, Dehong People's Hospital, Affiliated Dehong People's Hospital of Kunming Medical University, Dehong, China.
J Thorac Dis. 2021 Feb;13(2):1143-1150. doi: 10.21037/jtd-20-3312.
Preoperative localization of lung tumor mainly consisted of two methods: CT-guided percutaneous localization and electromagnetic navigation bronchoscopy-guided localization. However, these invasive methods could result in serious complications. In order to avoid the adverse effects of preoperative invasive localization, we propose a method of intraoperative noninvasive localization for lung tumors: clock dial integrated positioning (CDIP).
To retrospectively analyze the clinic data about the application of CDIP for 127 lung tumour patients in single utility port video-assisted thoracoscopic surgery (SUPVATS) between June 2017 and October 2017.
One hundred and twenty-four cases (97.64%) underwent thoracoscopic surgery, which including 14 lobectomy, 107 partial resection, 2 lobectomy plus partial resection and 1 left pneumonectomy. Three cases (2.36%) underwent thoracoscopic biopsy. The mean operation time and intraoperative bleeding were 47.9±22.1 min and 70.1±40.3 mL, respectively. The mean postoperative hospital stay and chest drain duration were 3.9±2.2 and 3.6±1.8 days, respectively. There were 118 cases of malignant tumors, including adenocarcinoma (n=101), squamous cell carcinoma (n=9), large cell carcinoma (n=2), small cell lung carcinoma (n=3), and metastatic lung carcinoma (n=3). The remaining nine cases were benign tumors, including granuloma (n=3), intrapulmonary lymph node (n=2), sclerosing hemangioma (n=2), and hamartoma (n=2). The incidence of postoperative complications was 10.2%. There was no mortality, secondary operation, or conversion to open procedure due to massive intraoperative bleeding.
CDIP combined with SUPVATS is a safe, feasible, and effective method for the localization of lung tumors. This novel method can provide a reliable alternative technique when the marker is dislocated.
肺肿瘤的术前定位主要有两种方法：CT引导下经皮定位和电磁导航支气管镜引导下定位。然而，这些侵入性方法可能会导致严重并发症。为了避免术前侵入性定位的不良影响，我们提出了一种肺肿瘤术中无创定位方法：时钟表盘综合定位法（CDIP）。
回顾性分析2017年6月至2017年10月期间127例接受单操作孔电视辅助胸腔镜手术（SUPVATS）的肺肿瘤患者应用CDIP的临床资料。
124例（97.64%）接受了胸腔镜手术，其中包括14例肺叶切除术、107例部分切除术、2例肺叶切除加部分切除术和1例左全肺切除术。3例（2.36%）接受了胸腔镜活检。平均手术时间和术中出血量分别为47.9±22.1分钟和70.1±40.3毫升。平均术后住院时间和胸腔引流时间分别为3.9±2.2天和3.6±1.8天。恶性肿瘤118例，包括腺癌（n = 101）、鳞状细胞癌（n = 9）、大细胞癌（n = 2）、小细胞肺癌（n = 3）和肺转移癌（n = 3）。其余9例为良性肿瘤，包括肉芽肿（n = 3）、肺内淋巴结（n = 2）、硬化性血管瘤（n = 2）和错构瘤（n = 2）。术后并发症发生率为10.2%。无因术中大出血导致的死亡、二次手术或转为开放手术。
CDIP联合SUPVATS是一种安全、可行且有效的肺肿瘤定位方法。当标志物移位时，这种新方法可以提供一种可靠的替代技术。
