Song Seung Hwan, Lee Hyun Soo, Moon Duk Hwan, Lee Sungsoo
Department of Thoracic and Cardiovascular Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Department of Thoracic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
J Chest Surg. 2021 Dec 5;54(6):494-499. doi: 10.5090/jcs.21.035.
A recent increase in the incidental detection of ground glass nodules (GGNs) has created a need for improved diagnostic accuracy in screening for malignancies. However, surgical diagnosis remains challenging, especially via video-assisted thoracoscopic surgery (VATS). Herein, we present the efficacy of a novel electrical navigation system for perioperative percutaneous transthoracic nodule localization.
Eighteen patients with GGNs who underwent electromagnetic navigated percutaneous transthoracic needle localization (ETTNL), followed by 1-stage diagnostic wedge resections via VATS between January and December 2020, were included in the analysis. Data on patient characteristics, nodules, procedures, and pathological diagnoses were collected and retrospectively reviewed.
Of the 18 nodules, 17 were successfully localized. Nine nodules were pure GGNs, and the remaining 9 were part-solid GGNs. The median nodule size was 9.0 mm (range, 4.0-20.0 mm); and the median depth from the visceral pleura was 5.2 mm (range, 0.0-14.4 mm). The median procedure time was 10 minutes (range, 7-20 minutes). The final pathologic results showed benign lesions in 3 cases and malignant lesions in 15 cases.
Perioperative ETTNL appears to be an effective method for the localization of GGNs, providing guidance for a 1-stage VATS procedure.
近期磨玻璃结节（GGN）偶然发现率的增加使得提高恶性肿瘤筛查的诊断准确性成为必要。然而，手术诊断仍然具有挑战性，尤其是通过电视辅助胸腔镜手术（VATS）。在此，我们展示一种新型电子导航系统在围手术期经皮经胸结节定位中的有效性。
分析纳入了2020年1月至12月期间18例接受电磁导航经皮经胸针定位（ETTNL），随后通过VATS进行一期诊断性楔形切除术的GGN患者。收集并回顾性分析患者特征、结节、手术及病理诊断等数据。
18个结节中，17个成功定位。9个结节为纯GGN，其余9个为部分实性GGN。结节中位大小为9.0mm（范围4.0 - 20.0mm）；距脏层胸膜的中位深度为5.2mm（范围0.0 - 14.4mm）。中位手术时间为10分钟（范围7 - 20分钟）。最终病理结果显示3例为良性病变，15例为恶性病变。
围手术期ETTNL似乎是GGN定位的有效方法，可为一期VATS手术提供指导。
