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术前 CT 引导下钩丝定位孤立性肺结节在电视辅助胸腔镜手术中的临床价值及应用。

Clinical value and application of preoperative CT-guided hookwire localization of solitary pulmonary nodules for video-assisted thoracic surgery.

机构信息

Department of Radiology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China.

The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.

出版信息

Technol Health Care. 2022;30(S1):459-467. doi: 10.3233/THC-THC228042.

Abstract

BACKGROUND

Video-assisted thoracic surgery (VATS) is a minimally invasive technique for the diagnosis and management of small pulmonary nodular lesions However, the identification of some lung nodules remains difficult.

OBJECTIVE

This research aimed to investigate the clinical value of preoperative computed tomography (CT)-guided hookwire localization of solitary pulmonary nodules (SPNs) for thoracoscopic resection.

METHODS

Seventy-one patients with 74 SPNs underwent VATS wedge resection after CT-guided hookwire localization. The mean diameter of the SPNs was 8.50 ± 4.53 mm,,besides, the mean distance from the SPNs to the parietal pleura was 16.81 ± 5.23 mm.

RESULTS

Sixty-nine of the 74 nodules were successfully localized using a CT-guided hookwire. The success rate of CT-guided localization was 93.2%. The average localization time was 15.23 ± 7.21 min per lesion. Seven patients (9.5%) had asymptomatic pneumothorax and 10 (13.5%) had minimal needle tract parenchymal hemorrhages after localization no clinical intervention was required for these patients. The rate of success for VATS wedge resection of the SPNs was 100%. Histological analysis of the SPNs revealed malignant disease in 67.4% of the patients.

CONCLUSIONS

Preoperative CT-guided hookwire localization for thoracoscopic resection is a safe and effective operation for the identification and stable fixation of SPNs.

摘要

背景

电视辅助胸腔镜手术(VATS)是一种诊断和治疗小肺结节性病变的微创技术。然而,一些肺结节的识别仍然存在困难。

目的

本研究旨在探讨术前 CT 引导下Hookwire 定位孤立性肺结节(SPN)在胸腔镜切除中的临床价值。

方法

71 例 74 个 SPN 患者在 CT 引导下 Hookwire 定位后行 VATS 楔形切除术。SPN 的平均直径为 8.50 ± 4.53mm,SPN 到壁层胸膜的平均距离为 16.81 ± 5.23mm。

结果

69 个结节用 CT 引导的 Hookwire 成功定位。CT 引导定位成功率为 93.2%。每个病灶的平均定位时间为 15.23 ± 7.21min。7 例(9.5%)患者出现无症状性气胸,10 例(13.5%)患者在定位后出现少量针道实质内出血,这些患者无需临床干预。SPN 的 VATS 楔形切除术成功率为 100%。对 SPN 的组织学分析显示,67.4%的患者患有恶性疾病。

结论

术前 CT 引导下 Hookwire 定位胸腔镜切除是一种安全有效的手术,可用于识别和稳定固定 SPN。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73bc/9028665/6f870ba98601/thc-30-thc228042-g001.jpg

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