Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Thorac Cardiovasc Surg. 2024 Feb;167(2):498-507.e2. doi: 10.1016/j.jtcvs.2023.05.034. Epub 2023 Jun 9.
To compare the efficacy and safety of preoperative localization of small pulmonary nodules (SPNs) with 4-hook anchor device and hook-wire before video-assisted thoracoscopic surgery.
Patients with SPNs scheduled for computed tomography-guided nodule localization before video-assisted thoracoscopic surgery between May 2021 and June 2021 at our center were randomized to either 4-hook anchor group or hook-wire group. The primary end point was intraoperative localization success.
After randomization, 28 patients with 34 SPNs were assigned to the 4-hook anchor group and 28 patients with 34 SPNs to the hook-wire group. The operative localization success rate was significantly greater in the 4-hook anchor group than in the hook-wire group (94.1% [32/34] vs 64.7% [22/34]; P = .007). All lesions in the 2 groups were successfully resected under thoracoscopy, but 4 patients in the hook-wire group who required transition from wedge resection to segmentectomy or lobectomy because of unsuccessful localization. Total localization-related complication rate was significantly lower in the 4-hook anchor group than in the hook-wire group (10.3% [3/28] vs 50.0% [14/28]; P = .004). The rate of chest pain requiring analgesia after the localization procedure was significantly lower in the 4-hook anchor group than in the hook-wire group (0 vs 5/28, 17.9%; P = .026). There were no significant differences in localization technical success rate, operative blood loss, hospital stay length and hospital cost between the 2 groups (all P > .05).
The use of the 4-hook anchor device for SPN localization offers advantages over the traditional hook-wire technique.
比较术前使用 4 钩锚定装置和钩线对小肺结节（SPN）进行定位在胸腔镜辅助手术中的疗效和安全性。
本研究为前瞻性随机对照研究，选取 2021 年 5 月至 2021 年 6 月于我院行 CT 引导下 SPN 定位后胸腔镜辅助手术的患者，随机分为 4 钩锚定组或钩线组。主要观察指标为术中定位成功率。
共纳入 56 例患者，每组各 28 例，共 56 个 SPN。4 钩锚定组的操作定位成功率明显高于钩线组（94.1% [32/34] vs 64.7% [22/34]；P=0.007）。两组均成功完成胸腔镜下切除，但钩线组有 4 例因定位失败而改行楔形切除术或肺段切除术或肺叶切除术。4 钩锚定组的总定位相关并发症发生率明显低于钩线组（10.3% [3/28] vs 50.0% [14/28]；P=0.004）。4 钩锚定组定位后胸痛需止痛治疗的发生率明显低于钩线组（0 vs 5/28，17.9%；P=0.026）。两组间定位技术成功率、术中出血量、住院时间和住院费用差异均无统计学意义（均 P>0.05）。
与传统的钩线技术相比，使用 4 钩锚定装置对 SPN 进行定位具有优势。
