Chen-Yoshikawa Toyofumi Fengshi, Nakamura Shota, Ueno Harushi, Kadomatsu Yuka, Kato Taketo, Mizuno Tetsuya
Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
Cancers (Basel). 2024 Sep 26;16(19):3284. doi: 10.3390/cancers16193284.
The widespread implementation of lung cancer screening and thin-slice computed tomography (CT) has led to the more frequent detection of small nodules, which are commonly referred to thoracic surgeons. Surgical resection is the final diagnostic and treatment option for such nodules; however, surgeons must perform preoperative or intraoperative markings for the identification of such nodules and their precise resection. Historically, hook-wire marking has been performed more frequently worldwide; however, lethal complications, such as air embolism, have been reported. Therefore, several surgeons have recently attempted to develop novel preoperative and intraoperative markers. For example, transbronchial markings, such as virtual-assisted lung mapping and intraoperative markings using cone-beam computed tomography, have been developed. This review explores various marking methods that have been practically applied for a better understanding of preoperative and intraoperative markings in thoracic surgery. Recently, several attempts have been made to perform intraoperative molecular imaging and dynamic virtual three-dimensional computed tomography for the localization, diagnosis, and margin assessment of small nodules. In this narrative review, the current status and future perspectives of preoperative and intraoperative markings in thoracic surgery are examined for a better understanding of these techniques.
肺癌筛查和薄层计算机断层扫描（CT）的广泛应用导致小肺结节的检出更为频繁，这些小肺结节通常会被转交给胸外科医生。手术切除是此类结节的最终诊断和治疗选择；然而，外科医生必须在术前或术中进行标记，以识别这些结节并进行精确切除。从历史上看，钩丝标记在全球范围内应用更为频繁；然而，已经有空气栓塞等致命并发症的报道。因此，最近一些外科医生试图开发新型的术前和术中标记物。例如，已经开发了经支气管标记，如虚拟辅助肺绘图和使用锥形束计算机断层扫描的术中标记。本综述探讨了各种已实际应用的标记方法，以便更好地理解胸外科手术中的术前和术中标记。最近，人们尝试进行术中分子成像和动态虚拟三维计算机断层扫描，用于小肺结节的定位、诊断和切缘评估。在这篇叙述性综述中，我们对胸外科手术中术前和术中标记的现状及未来前景进行了研究，以便更好地理解这些技术。
