Tian Dong, Zhao Jia-Sheng, Yan Hao-Ji, Jin Xiao-Han, Li Tao, Chen Long-Qi
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Department of Thoracic Surgery, The First Hospital of China Medical University, Shenyang, China.
J Thorac Dis. 2025 Jun 30;17(6):3658-3666. doi: 10.21037/jtd-2025-54. Epub 2025 Jun 23.
Thoracoscopic sublobar resection for non-surface or non-solid nodules is sometimes challenging for localization. We have developed a novel technique for localizing pulmonary nodules through percutaneous catheter puncture to assist thoracoscopic sublobar resection. This study aimed to assess the safety, efficacy and suitability of the localization technique.
This prospective study enrolled patients who underwent wedge resection from September 2023 to July 2024. Based on the projection site of the pulmonary nodules on the chest wall in the preoperative computed tomography images, the puncture point was determined through the closest intercostal space to achieve percutaneous catheter puncture localization. The primary outcomes included safety (complication rate) and efficacy (successful resection rate, distance from localization point to the nodule and surgical margin). The secondary outcomes included suitability (localization times and patient comfort).
In total, 107 patients underwent wedge resection with percutaneous catheter puncture localization. The lesions of all patients (100%) were successfully resected. The median surgical margin was 2 cm (range, 1.5-3 cm). The distance from the localization point to the nodule was less than or equal to 1.5 cm in all patients, less than or equal to 1 cm in 87.9%, and less than 0.5 cm in 39.3% of patients. None of the patients (0%) experienced any complications or felt pain. The localization time of all patients was less than 5 minutes.
Our preliminary experience has found that localizing pulmonary nodules through percutaneous catheter puncture technique is safe, painless, effective, and suitable prior to sublobar resection.
对于非表面或非实性结节进行胸腔镜亚肺叶切除时，定位有时具有挑战性。我们开发了一种通过经皮导管穿刺定位肺结节的新技术，以辅助胸腔镜亚肺叶切除。本研究旨在评估该定位技术的安全性、有效性和适用性。
这项前瞻性研究纳入了2023年9月至2024年7月接受楔形切除术的患者。根据术前计算机断层扫描图像中肺结节在胸壁上的投影部位，通过最接近的肋间间隙确定穿刺点，以实现经皮导管穿刺定位。主要结局包括安全性（并发症发生率）和有效性（成功切除率、定位点到结节的距离以及手术切缘）。次要结局包括适用性（定位时间和患者舒适度）。
共有107例患者接受了经皮导管穿刺定位的楔形切除术。所有患者（100%）的病变均成功切除。手术切缘中位数为2 cm（范围1.5 - 3 cm）。所有患者定位点到结节的距离均小于或等于1.5 cm，87.9%的患者小于或等于1 cm，39.3%的患者小于0.5 cm。所有患者（0%）均未出现任何并发症或感到疼痛。所有患者的定位时间均小于5分钟。
我们的初步经验发现，经皮导管穿刺技术在亚肺叶切除术前定位肺结节是安全、无痛、有效的且适用的。
