Liu Dehao, Zhang Rongzhou, Yu Xiuyi, Liao Liangzhong, Shi Sien, Chen Lichun
Department of Radiology, The First Affiliated Hospital of Xiamen University, SiMing, Xiamen, Fujian, China.
Department of Thoracic surgery, The First Affiliated Hospital of Xiamen University, SiMing, Xiamen, Fujian, China.
Wideochir Inne Tech Maloinwazyjne. 2023 Dec;18(4):680-689. doi: 10.5114/wiitm.2023.133073. Epub 2023 Nov 20.
Preoperative computed tomography (CT)-guided localization can shorten the time of video-assisted thoracoscopic surgery (VATS) and accurately aid in pulmonary nodule removal.
To discuss the application value and safety of 2 kinds of breast localization needles and anchor localization needles in clinical practice for pulmonary nodules under CT guidance before VATS.
We retrospectively studied 215 patients with 247 pulmonary nodules, who underwent CT-guided pulmonary nodule location before VATS. The 2 kinds of localization needles were randomly used, and we collected and analysed the clinical data.
We used breast and anchor localization needles in 27.9% and 72.1% of cases, respectively. Differences were observed in puncture localization time, detachment rate, and visual analogue scale (VAS). The detachment rate (0%) and positioning time (median: 12 min) were less in the anchor than in the breast localization needle group (8.7% and median: 13 min, respectively). The median VAS was approximately 2 and 5 in the anchor and breast localization needle groups, respectively. Surgical pathology revealed that 155 (62.8%) pulmonary nodules were malignant while 92 (37.2%) were benign. The primary distinction in surgical procedures is the higher proportion of segmental resections in the middle and inner band group (19.3%) compared to the periphery band group (4.2%).
Unlike breast localization needles, anchor localization needles can reduce pain and discomfort after positioning, and they are not easy to decouple. These 2 needles are safe for CT-guided localization, which can shorten the time of VATS and accurately aid in pulmonary nodule removal.
术前计算机断层扫描(CT)引导下的定位可缩短电视辅助胸腔镜手术(VATS)的时间,并准确辅助切除肺结节。
探讨两种乳腺定位针和锚定定位针在VATS术前CT引导下肺结节临床实践中的应用价值及安全性。
我们回顾性研究了215例患有247个肺结节的患者,这些患者在VATS术前接受了CT引导下的肺结节定位。随机使用两种定位针,并收集和分析临床数据。
我们分别在27.9%和72.1%的病例中使用了乳腺定位针和锚定定位针。在穿刺定位时间、脱离率和视觉模拟评分(VAS)方面观察到差异。锚定定位针组的脱离率(0%)和定位时间(中位数:12分钟)低于乳腺定位针组(分别为8.7%和中位数:13分钟)。锚定定位针组和乳腺定位针组的VAS中位数分别约为2和5。手术病理显示,155个(62.8%)肺结节为恶性,92个(37.2%)为良性。手术方式的主要区别在于中内带组节段性切除的比例(19.3%)高于外周带组(4.2%)。
与乳腺定位针不同,锚定定位针可减轻定位后的疼痛和不适,且不易脱开。这两种针在CT引导定位中是安全的,可缩短VATS的时间并准确辅助切除肺结节。