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CT引导下基于医用粘合剂的定位方法在亚肺叶切除术中应用以确保手术切缘的分析

Analysis on the application of a CT-guided medical adhesive-based localization method in sublobectomy to ensure surgical margins.

作者信息

Yu Shanhai, Duan Xianling, Ma Jungang, Li Wei, Zhang Nianxin, Liu Xiangding, Yan Zhizhong, Zhang Yuyin, Wang Lixiang, Zhang Liwei

机构信息

Department of Thoracic Surgery, Juxian People's Hospital, Rizhao, Shandong Province, China.

Operating Room, Juxian People's Hospital, Rizhao, Shandong Province, China.

出版信息

BMC Pulm Med. 2025 Jul 2;25(1):305. doi: 10.1186/s12890-025-03762-2.

Abstract

BACKGROUND

Sublobectomy is one of the standard surgical procedures for early stage lung cancer. The distance of resection margin is the basic demand of sublobectomy. Therefore, it is of great clinical significance to ensure the margin distance in sublobectomy. How to ensure the margin distance in sublobectomy is still a difficult problem for thoracic surgeons. Our center has recently adopted the CT-guided medical adhesive localization method to solve the problem of insufficient lung margins with excellent results.

METHODS

The clinical data of 40 patients with pulmonary nodules, who received VATS-based sublobectomy during the period from January 2022 to February 2023 in the Department of Thoracic Surgery, Juxian People's Hospital, Shandong Province, were retrospectively analyzed. All the patients underwent CT-guided lung puncture for medical adhesive-based pulmonary nodule localization before surgery. After resection, the distance between the pulmonary nodule and the surgical margin was measured, and the surgical margin was routinely sent for examination. The clinical case data of the patients were collected.

RESULTS

All the 40 patients in the group successfully underwent percutaneous lung puncture for medical adhesive-based localization under local anesthesia. For all the patients, the distance between the lesion and the surgical margin was greater than 2 cm, and the surgical margin tested negative, with a localization success rate of 100%, and a localization duration of (15.0 ± 3.6) min. Localization complications included 2 cases of slight pneumothorax, 2 cases of bleeding along the needle tract, and 1 case of hemoptysis, none of which required special treatment.

CONCLUSION

CT-guided medical adhesive-based localization is a safe, effective and simple localization method, which has important clinical application value in ensuring the safety of surgical margins of pulmonary nodules and reducing the time needed to locate lesions during surgery.

摘要

背景

肺段切除术是早期肺癌的标准手术方式之一。切缘距离是肺段切除术的基本要求。因此,在肺段切除术中确保切缘距离具有重要的临床意义。如何在肺段切除术中确保切缘距离仍是胸外科医生面临的难题。我们中心最近采用CT引导下医用胶定位法解决了肺切缘不足的问题,效果良好。

方法

回顾性分析2022年1月至2023年2月在山东省莒县人民医院胸外科接受电视胸腔镜辅助肺段切除术的40例肺结节患者的临床资料。所有患者术前均接受CT引导下经皮肺穿刺注入医用胶进行肺结节定位。切除后,测量肺结节与手术切缘之间的距离,并常规送检手术切缘。收集患者的临床病例资料。

结果

该组40例患者均在局部麻醉下成功进行了经皮肺穿刺医用胶定位。所有患者病变与手术切缘的距离均大于2 cm,手术切缘检查阴性,定位成功率为100%,定位时间为(15.0±3.6)分钟。定位并发症包括2例轻度气胸、2例针道出血和1例咯血,均无需特殊处理。

结论

CT引导下医用胶定位是一种安全、有效、简便的定位方法,在确保肺结节手术切缘安全及减少术中病变定位所需时间方面具有重要的临床应用价值。

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