Tang Hai, Yue Peng, Wei Ning, Zhang Lei, Hu Wenteng, Sun Weiyan, Cao Xiong, Liu Lixin, Lin Ruijiang, Xu Shangqing, Wang Chenhan, Ma Xiang, She Yunlang, Ma Minjie, Chen Chang
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Shanghai Engineering Research Center of Lung Transplantation, Shanghai, China.
JTCVS Tech. 2022 Oct 8;16:139-148. doi: 10.1016/j.xjtc.2022.10.003. eCollection 2022 Dec.
Localization of pulmonary nodules is challenging. However, traditional localization methods have high radiation doses and a high risk of complications. We developed a noninvasive 3-dimensional printing navigational template for intraoperative localization. It can reduce puncture-related complications and simplify the localization process. This study will verify the feasibility of this method.
Patients with peripheral pulmonary nodules were included in this study. The computed tomography scan sequences were obtained to design a digital template model, which was then imported into a 3-dimensional printer to produce a physical navigational template. Finally, the navigational template is placed into the patient's pleural cavity for intraoperative localization. The precision of the nodule localization and associated complications were evaluated.
Twelve patients were finally included in this study. Intraoperative navigational template localization was used in all patients. The success rate of intraoperative nodule localization was 100%, and the median time of localization was 19.5 minutes (range, 16-23.5 minutes). The deviation median of the navigational template was 2.1 mm (range, 1.1-2.7 mm). Among the included patients, no significant complications occurred during intraoperative localization.
The 3-dimensional printing template for intraoperative localization is feasible, will cause no trauma to the patient, and has acceptable accuracy for application in nodules localization. This navigational template greatly simplifies the localization process and may potentially break the dependence of percutaneous localization on computed tomography scanning.
肺结节的定位具有挑战性。然而,传统的定位方法辐射剂量高且并发症风险大。我们开发了一种用于术中定位的无创三维打印导航模板。它可以减少穿刺相关并发症并简化定位过程。本研究将验证该方法的可行性。
本研究纳入了周围型肺结节患者。获取计算机断层扫描序列以设计数字模板模型,然后将其导入三维打印机以制作物理导航模板。最后,将导航模板置于患者胸腔内进行术中定位。评估结节定位的精度和相关并发症。
本研究最终纳入12例患者。所有患者均采用术中导航模板定位。术中结节定位成功率为100%,定位中位时间为19.5分钟(范围16 - 23.5分钟)。导航模板的中位偏差为2.1毫米(范围1.1 - 2.7毫米)。纳入的患者中,术中定位期间未发生明显并发症。
术中定位的三维打印模板是可行的,不会对患者造成创伤,在结节定位应用中具有可接受的准确性。这种导航模板极大地简化了定位过程,可能会打破经皮定位对计算机断层扫描的依赖。