摘要
背景与目的肺结节定位关系到能否精准、快捷找到并切除病灶,是微创胸腔镜手术(video-assisted thoracic surgery,VATS)成功的重要环节。本研究探讨单一肺结节与两枚以上肺结节VATS术前计算机断层扫描(computed tomography,CT)引导下医用胶定位的可行性,并与单个结节定位的准确性、安全性进行比较。方法回顾2018年11月-2021年3月我院VATS术前行CT引导下医用胶定位单侧肺部结节患者的临床资料,按定位结节的数量分为单一结节定位组与多个结节定位组(定位结节数≥2个)。对比两组患者定位时间、成功率、并发症发生率等。结果两组共126例结节,其中单一结节定位组62例,多个结节定位组64例。平均单个结节定位时间单一结节定位组为(13.23±4.5)min,多个结节定位组为(10.52±2.8)min,两组间差异有统计学意义(P<0.05)。单一结节定位组定位成功率为100%,多个结节定位组为98.4%,两组无统计学差异(P>0.05)。定位后所有胸腔镜手术均顺利完成。多个结节定位组气胸的发生率明显高于单一结节定位组(P=0.07)。结论与单侧肺结节定位相比,单侧CT引导下胸腔镜下医用胶定位多发性肺结节也是可行和准确的,值得临床应用。但应注意气胸发生率较高。
Background and objective The localization of pulmonary nodules is related to whether the lesions can be found and removed accurately and quickly.It is an important link for the success of minimally invasive video-assisted thoracic surgery(VATS).This study investigated the feasibility of medical glue localization under VATS video-assisted thoracoscopic computed tomography(CT)guidance for single pulmonary nodule and more than two pulmonary nodules,and compared with the accuracy and safety of single nodule localization.Methods A retrospective analysis of the clinical data of patients who underwent unilateral CT-guided medical glue localization before VATS from November 2018 to March 2021 were performed,the patients was divided into multiple pulmonary nodules group(localized nodules≥2)and single pulmonary nodule group according to the number of localized nodules.The localization time,success rate and complication rate of the two groups were compared.Results There were 126 nodules in the two groups,including 62 in single pulmonary nodule group and 64 in multiple pulmonary nodules group.The average single nodule localization time was(13.23±4.5)min in single pulmonary nodule group and(10.52±2.8)min in multiple pulmonary nodules group,the difference between the two groups is statistically significant(P<0.05).The localization success rate of single pulmonary nodule group and multiple pulmonary nodules group were 100%and 98.4%separately,the difference between the two groups was not statistically significant(P>0.05).All VATS were successfully completed after localization.The incidence of pneumothorax was higher in multiple pulmonary nodules group than in single pulmonary nodule group(P=0.07).Conclusion Compared with localization of single lung nodule,unilateral CT-guided medical glue localization for multiple pulmonary nodules before VATS is also feasible and accuracy,it is worthy of clinical application.But the higher rate of pneumothorax should be paid attention to.
作者
谭晓刚
刘宝东
张毅
Xiaogang TAN;Baodong LIU;Yi ZHANG(Department of Thoracic Surgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《中国肺癌杂志》
CAS
CSCD
北大核心
2022年第1期1-6,共6页
Chinese Journal of Lung Cancer
基金
首都医科大学临床专科学院(系)开放课题(No.RG00667)资助。
关键词
多发肺结节
医用胶定位
胸腔镜手术
Multiple pulmonary nodules
Medical glue localization
Thoracoscopy surgery
