Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Radiology, Xuzhou Central Hospital, Xuzhou, China.
J Cardiothorac Surg. 2023 Jul 5;18(1):217. doi: 10.1186/s13019-023-02304-3.
Video-assisted thoracoscopic surgery (VATS) is an approach that is commonly used to resect pulmonary nodules (PNs). However, when these PNs are located behind the scapula, a transscapular access approach is generally required. In this study, the safety, efficacy, and feasibility of preoperative computed tomography (CT)-guided Sens-cure needle (SCN) localization was assessed for PNs located behind the scapula.
From January 2020 - June 2022, a total of 122 PN patients in our hospital underwent preoperative CT-guided SCN localization and subsequent VATS resection, of whom 12 (9.8%) exhibited PNs behind the scapula necessitating a transscapular approach for this localization procedure.
This study included 12 patients, each of whom had one PN located behind the scapula. The CT-guided transscapular SCN localization approach was successful in all patients, and no complications near the operative site were observed. The median localization time was 12 min, and 2 (16.7%) and 1 (8.3%) patients respectively developed pneumothorax and pulmonary hemorrhage after the localization procedure was complete. Wedge resection procedures for these PNs achieved technical success in all cases. Four patients were diagnosed with invasive adenocarcinomas and subsequently accepted lobectomy and systematic lymph node dissection. The median VATS duration and the median blood loss was 80 min and 10 mL, respectively. In total, 3, 5, and 4 PNs were respectively diagnosed as benign, mini-invasive adenocarcinomas, and invasive adenocarcinomas.
Preoperative CT-guided transscapular SCN localization represents a safe, straightforward, and effective means of localizing PNs present behind the scapula.
电视辅助胸腔镜手术（VATS）是一种常用于切除肺部结节（PNs）的方法。然而，当这些 PNs 位于肩胛骨后面时，通常需要经肩胛骨入路。在这项研究中，评估了术前 CT 引导下 Sens-cure 针（SCN）定位对肩胛骨后面 PNs 的安全性、有效性和可行性。
从 2020 年 1 月至 2022 年 6 月，我院共有 122 例 PN 患者接受术前 CT 引导下 SCN 定位和随后的 VATS 切除，其中 12 例（9.8%）存在肩胛骨后面的 PNs，需要经肩胛骨入路进行此定位。
本研究共纳入 12 例患者，每人有一个位于肩胛骨后面的 PNs。所有患者均成功完成 CT 引导下经肩胛骨 SCN 定位，未观察到手术部位附近的并发症。定位时间中位数为 12 分钟，2 例（16.7%）和 1 例（8.3%）患者分别在定位完成后出现气胸和肺出血。这些 PNs 的楔形切除术均获得技术成功。4 例患者被诊断为浸润性腺癌，随后接受了肺叶切除术和系统淋巴结清扫术。VATS 持续时间和中位出血量中位数分别为 80 分钟和 10 毫升。共有 3、5 和 4 个 PNs 分别被诊断为良性、微侵袭性腺癌和浸润性腺癌。
术前 CT 引导下经肩胛骨 SCN 定位是一种安全、直接、有效的定位肩胛骨后面 PNs 的方法。
