Thoracic Surgery Unit, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Campania, Italy.
Oncology, Department of Precision Medicine, Università della Campania "L. Vanvitelli", Napoli, Campania, Italy.
Interact Cardiovasc Thorac Surg. 2022 Nov 8;35(6). doi: 10.1093/icvts/ivac234.
Application of video-assisted thoracoscopy brought lung surgery into the minimally invasive era; the lack of tactile feedback using VATS, remains a disadvantage because surgeons are unable to locate lesions with a finger or device. This study aimed to investigate the effectiveness, the applicability and the utility of intraoperative ultrasound (IU), for the localization of small ground-glass opacity (GGO) lesions in the parenchyma, as a guide in finding their margins in a deflated lung.
We included 15 consecutive patients undergoing diagnostic resection of GGOs via VATS in the Thoracic Surgery Unit of the University of 'Luigi Vanvitelli' of Naples from November 2019 to December 2021. They were under general anaesthesia, when the lung had been collapsed, the probe was placed in the region where the target lesion was thought to reside on the basis of low-dose computed tomography scanning. GGO could be identified their sizes, echo levels and posterior echo was recorded by IU when the lung was completely deflated.
We conducted a retrospective single-centre study. All GGOs were identified by IU. The mean size and depth were 14.1 ± 0.5 and 4.8 ± 0.3 mm, respectively. Six (40%) lesions had hyperechoic patterns, 9 (60%) had mixed echogenicity where the hyperechoic patterns were irregularly mixed with hypoechoic patterns. The final diagnoses included 2 (15%) atypical adenomatous hyperplasia; 2 (15%) adenocarcinomas in situ; 3 (23%) minimally invasive adenocarcinomas and 6 (46%) invasive adenocarcinomas.
The results of our study showed that IU could safely and effectively detect GGOs.
胸腔镜的应用使肺外科进入了微创时代；由于外科医生无法用手指或器械定位病变，因此 VATS 缺乏触觉反馈仍然是一个缺点。本研究旨在探讨术中超声（IU）在定位肺实质内小磨玻璃密度（GGO）病变中的有效性、适用性和实用性，作为在充气肺中寻找其边界的指南。
我们纳入了 2019 年 11 月至 2021 年 12 月期间在那不勒斯 Luigi Vanvitelli 大学胸外科接受 VATS 诊断性切除 GGO 的 15 例连续患者。他们接受全身麻醉，当肺萎陷时，根据低剂量计算机断层扫描将探头放置在目标病变被认为存在的区域。当肺完全萎陷时，通过 IU 可以识别 GGO 的大小、回声水平和后向回声。
我们进行了一项回顾性单中心研究。所有 GGO 均通过 IU 识别。平均大小和深度分别为 14.1±0.5mm 和 4.8±0.3mm。6 个（40%）病变呈高回声模式，9 个（60%）病变呈混合回声，其中高回声模式不规则地混合低回声模式。最终诊断包括 2 例（15%）非典型腺瘤性增生；2 例（15%）原位腺癌；3 例（23%）微浸润性腺癌和 6 例（46%）浸润性腺癌。
我们的研究结果表明，IU 可以安全有效地检测 GGO。
