Department of Thoracic Surgery, Juxian People's Hospital, Rizhao, 276599, Shandong, China.
Department of Interventional Medicine, Juxian People's Hospital, Rizhao, 276599, Shandong, China.
Clin Transl Oncol. 2023 Oct;25(10):2931-2937. doi: 10.1007/s12094-023-03156-y. Epub 2023 Apr 5.
To explore the application value of CT-guided localization using a coil in combination with medical adhesive in sublobar resection.
The clinical data of 90 patients who had small pulmonary nodules and received thoracoscopic sublobar resection during the period from September 2021 to October 2022 in the Department of Thoracic Surgery, Juxian People's Hospital, Shandong Province, were retrospectively analyzed.
The diameters of 95 pulmonary nodules in the 90 patients in the whole group ranged from 0.40 to 1.24 cm, and their distances from the visceral pleura ranged from 0.51 to 2.15 cm. In these patients, percutaneous lung puncture was successfully performed under local anesthesia, through which coils were implanted in the nodules and medical adhesive was injected around the nodules, with a success rate of localization of 100%. Localization complications included 10 cases of asymptomatic pneumothorax, 9 cases of intrapulmonary hemorrhage, 5 cases of severe pain, and 1 case of pleural reaction, all of which required no special treatment. After preoperative localization, the success rate of resection of pulmonary nodules was 100%, and sufficient surgical margins were obtained.
CT-guided localization using a coil in combination with medical adhesive is a safe, effective, and simple localization method that can meet the requirements of thoracic surgeons for intraoperative localization; for small pulmonary nodules, especially those small-sized and deep-located ground-glass nodules containing few solid mass, this method has important clinical application value, which is a preoperative localization technique worthy of wide application in clinical practice.
探讨 CT 引导下使用线圈联合医用胶行亚肺叶切除术定位的应用价值。
回顾性分析 2021 年 9 月至 2022 年 10 月山东省莒县人民医院胸外科收治的 90 例行胸腔镜亚肺叶切除术的肺部小结节患者的临床资料。
90 例患者共 95 个肺部小结节,直径 0.40~1.24 cm,距脏层胸膜距离 0.51~2.15 cm。所有患者均在局麻下经皮肺穿刺成功植入线圈并于瘤周注射医用胶,定位成功率为 100%。定位相关并发症包括无症状气胸 10 例、肺内出血 9 例、剧烈疼痛 5 例、胸膜反应 1 例,均无需特殊处理。术前定位后,所有患者均 100%顺利完成肺结节切除术,均获得足够的手术切缘。
CT 引导下使用线圈联合医用胶行亚肺叶切除术定位安全、有效、简单,能满足胸外科医师对术中定位的要求;对于肺部小结节,尤其是直径小、位置深、含实性成分少的磨玻璃结节,该方法具有重要的临床应用价值,是一种值得在临床实践中广泛应用的术前定位技术。