Yamamoto Yoko, Ikeda Naoki, Nakamura Masahisa
Department of General Thoracic Surgery, Sakai City Medical Center Hospital, Ebaraji-Cho, Nishi-Ku, Sakai-Shi, Osaka, 593-8304, Japan.
Department of Radiology, Sakai City Medical Center Hospital, Ebaraji-Cho, Nishi-Ku, Sakai-Shi, Osaka, 593-8304, Japan.
J Cardiothorac Surg. 2024 Dec 30;19(1):692. doi: 10.1186/s13019-024-03213-9.
The detection of tumor localization is difficult in robotic surgery because surgeons have no sense of touch and rely on visual information. This study aimed to evaluate the efficacy of preoperative CT-guided dye marking of lung nodules prior to robotic surgery.
Patients undergoing CT-guided dye marking prior to robotic surgery at our hospital between September 2019 and April 2024 were retrospectively analyzed.
Thirty lung nodules from 29 patients were analyzed. The dye marking procedure was successfully completed. Indigo carmine and indocyanine green were used for 20 and 10 pulmonary nodules, respectively. Slight pneumothorax was the most common complication and occurred in 6 patients (20.7%), none of whom required chest tube placement. Dye marking was visualized in 29/30 (96.7%) nodules and one nodule had poor intraoperative visualization due to severe adhesions. One patient underwent open thoracotomy because of difficulty ventilating one lung. Fourteen patients underwent wide wedge resection and 16 patients underwent segmentectomy for the target nodules. All target nodules were successfully resected with negative margins.
CT-guided dye marking of small pulmonary nodules prior to robotic surgery appears feasible and safe. This procedure can facilitate the performance of robotic sublobar resection.
在机器人手术中，肿瘤定位检测较为困难，因为外科医生没有触觉，只能依靠视觉信息。本研究旨在评估机器人手术前CT引导下对肺结节进行染料标记的有效性。
回顾性分析2019年9月至2024年4月在我院接受机器人手术前CT引导下染料标记的患者。
分析了29例患者的30个肺结节。染料标记程序成功完成。分别有20个和10个肺结节使用了靛胭脂和吲哚菁绿。轻度气胸是最常见的并发症，6例患者（20.7%）出现该并发症，均无需放置胸管。30个结节中有29个（96.7%）染料标记清晰可见，1个结节因严重粘连术中可视化效果差。1例患者因单肺通气困难接受了开胸手术。14例患者对目标结节进行了广泛楔形切除术，16例患者进行了肺段切除术。所有目标结节均成功切除，切缘阴性。
机器人手术前CT引导下对小肺结节进行染料标记似乎可行且安全。该程序可促进机器人亚肺叶切除术的实施。
