The First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou, China.
Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, China.
World J Surg Oncol. 2023 May 27;21(1):161. doi: 10.1186/s12957-023-03035-4.
To analyze and compare the clinical application value of three-dimensional reconstruction and computed tomography (CT)-guided Hook-wire localization for row lung segment resection of pulmonary nodules.
Retrospective analysis of the clinical data of 204 patients suffering from pulmonary nodules admitted to the Department of Thoracic Surgery of Gansu Provincial People's Hospital from June 2016 to December 2022. According to the preoperative positioning method, the group was divided into a 3D reconstruction group (98 cases) and a Hook-wire group (106 cases), respectively. The two groups of patients were propensity score matching (PSM) to compare their perioperative outcomes.
All patients in both groups underwent successful surgeries without perioperative deaths. After PSM, 79 patients were successfully matched in each group. Two cases of pneumothorax, three cases of hemothorax, and four cases of decoupling occurred in the Hook-wire group; no complications of pneumothorax, hemothorax, and decoupling occurred in the 3D reconstruction group. Compared to the Hook-wire group, the 3D reconstruction group has shorter operative time (P = 0.001), less intraoperative bleeding (P < 0.001), less total postoperative chest drainage (P = 0.003), shorter postoperative tube placement time (P = 0.001), shorter postoperative hospital stay (P = 0.026), and postoperative complications (P = 0.035). There was no statistically significant difference between the two groups in terms of pathological type, TNM staging, and number of lymph node dissection.
Three-dimensional reconstruction and localization of pulmonary nodules enables safe and effective individualized thoracoscopic anatomical lung segment resection with a low complication rate, which has good clinical application value.
分析比较三维重建与 CT 引导 Hook-wire 定位在肺段切除肺结节中的临床应用价值。
回顾性分析 2016 年 6 月至 2022 年 12 月甘肃省人民医院胸外科收治的肺结节患者 204 例的临床资料，根据术前定位方法分为三维重建组（98 例）和 Hook-wire 组（106 例），对两组患者行倾向性评分匹配（PSM）比较其围术期结果。
两组患者均顺利完成手术，无围术期死亡病例。PSM 后，每组各有 79 例患者成功匹配。Hook-wire 组发生气胸 2 例、血胸 3 例、脱钩 4 例，三维重建组无气胸、血胸、脱钩并发症。与 Hook-wire 组相比，三维重建组手术时间更短（P=0.001）、术中出血量更少（P<0.001）、总术后胸腔引流量更少（P=0.003）、术后置管时间更短（P=0.001）、术后住院时间更短（P=0.026）、术后并发症更少（P=0.035）。两组在病理类型、TNM 分期、淋巴结清扫数量等方面差异均无统计学意义。
三维重建与肺结节定位可安全、有效实施个体化胸腔镜解剖性肺段切除术，并发症发生率低，具有较好的临床应用价值。
