Department of Radiology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China.
J Cardiothorac Surg. 2021 Mar 25;16(1):55. doi: 10.1186/s13019-021-01446-6.
Preoperative computed tomography (CT)-guided coil localization (CL) is commonly used to facilitate video-assisted thoracoscopic surgery (VATS)-guided diagnostic wedge resection (WR) of pulmonary nodules (PNs). When a scapular-blocked PN (SBPN) is localized, the trans-scapular CL (TSCL) is commonly performed. In this study, we investigated the safety, feasibility, and clinical efficacy of preoperative CT-guided TSCL for SBPNs.
From January 2014 to September 2020, a total of 152 patients with PNs underwent CT-guided CL prior to VATS-guided WR. Of these patients, 14 had SBPNs and underwent the TSCL procedure.
A total of 14 SBPNs were localized in the 14 patients. The mean diameter of the 14 SBPNs was 7.4 ± 2.4 mm. The technical success rate of the scapula puncture was 100%. No complications occurred near the scapula. The technical success rate of CL was 92.9%. One coil dropped off when performing the VATS procedure. The mean duration of the TSCL was 14.2 ± 2.7 min. Two patients (14.3%) developed asymptomatic pneumothorax after TSCL. The technical success rate of VATS-guided WR was 92.9%. The patient who experienced technical failure of TSCL directly underwent lobectomy. The mean duration of the VATS was 90.0 ± 42.4 min and the mean blood loss was 62.9 ± 37.2 ml. The final diagnoses of the 14 SBPNs included invasive adenocarcinoma (n = 4), adenocarcinoma in situ (n = 9), and benign disease (n = 1).
Preoperative CT-guided TSCL is a safe and simple procedure that can facilitate high success rates of VATS-guided WR of SBPNs.
术前计算机断层扫描（CT）引导下线圈定位（CL）常用于辅助电视辅助胸腔镜手术（VATS）引导下的肺结节（PN）诊断性楔形切除术（WR）。当存在肩胛骨阻挡的 PN（SBPN）时，通常进行经肩胛骨 CL（TSCL）。在本研究中，我们研究了术前 CT 引导下 TSCL 用于 SBPN 的安全性、可行性和临床疗效。
2014 年 1 月至 2020 年 9 月，共有 152 例 PN 患者在 VATS 引导 WR 前行 CT 引导 CL。其中 14 例为 SBPN，行 TSCL 术。
共对 14 例 SBPN 患者进行了 14 次定位。14 例 SBPN 的平均直径为 7.4±2.4mm。肩胛骨穿刺的技术成功率为 100%。肩胛骨附近无并发症发生。CL 的技术成功率为 92.9%。在进行 VATS 手术时，1 个线圈脱落。TSCL 的平均时间为 14.2±2.7min。TSCL 后 2 例（14.3%）出现无症状气胸。VATS 引导 WR 的技术成功率为 92.9%。TSCL 技术失败的患者直接行肺叶切除术。VATS 的平均时间为 90.0±42.4min，平均出血量为 62.9±37.2ml。14 例 SBPN 的最终诊断包括浸润性腺癌（n=4）、原位腺癌（n=9）和良性疾病（n=1）。
术前 CT 引导下 TSCL 是一种安全、简单的方法，可提高 VATS 引导下 SBPN WR 的成功率。
