[1]许志扬 许建新* 关军 林建生 李志新①.微弹簧圈定位在胸腔镜肺小结节切除术中的应用[J].中国微创外科杂志,2017,17(3):228-230.
　Xu Zhiyang,Xu Jianxin,Guan Jun,et al.Clinical Application of CT-guided Microcoil Localization in Video-assisted Thoracoscopic Surgery for Solitary Small Pulmonary Nodules[J].Chinese Journal of Minimally Invasive Surgery,2017,17(3):228-230.
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微弹簧圈定位在胸腔镜肺小结节切除术中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年3期
页码:
228-230
栏目:
临床研究
出版日期:
2017-06-20

文章信息/Info

Title:
Clinical Application of CT-guided Microcoil Localization in Video-assisted Thoracoscopic Surgery for Solitary Small Pulmonary Nodules
作者:
许志扬 许建新* 关军 林建生 李志新①
福建医科大学教学医院莆田市第一医院胸外科，莆田351100
Author(s):
Xu Zhiyang;  Xu Jianxin;  Guan Jun;  et al.
Department of Thoracic Surgery, First Hospital of Putian, Putian 351100, China
关键词:
肺小结节; 微弹簧圈定位; 胸腔镜切除术
Keywords:
Solitary pulmonary nodule; Microcoil localization; Thoracoscopic resection
文献标志码:
A
摘要:
目的探讨术前CT引导下微弹簧圈定位在胸腔镜孤立性肺小结节切除术中的应用价值。方法2014年5月~2016年4月，对21例单发肺部小结节病灶经术前定位后行胸腔镜手术切除。结节直径7~21(10.3±8.0)mm，距离脏层胸膜深度5~23(10.2±4.3)mm。术前1日在CT引导下行“拖尾法”微弹簧圈术前定位，胸腔镜下行病灶楔形切除术，送冰冻病理，如为恶性继续行胸腔镜下肺叶切除加纵隔淋巴结清扫术。结果全组21例肺小结节均成功经皮肺穿刺置入微弹簧圈。定位并发症为无症状气胸3例，均无需处理。胸腔镜术中发现微弹簧圈脱位3例，定位成功率85.7％（18/21）。21例均行胸腔镜手术切除。病理确诊原位癌5例，腺癌11例，非典型腺瘤样增生1例，炎症2例，炎性假瘤1例，肺内转移瘤1例。结论CT引导下微弹簧圈定位用于肺内小结节术前定位是一种简单、直观、有效、精确的方法，值得推广。
Abstract:
ObjectiveTo evaluate the value of CT-guided microcoil localization for pulmonary small nodule resection under video-assisted thoracoscopic surgery (VATS).MethodsWe performed CT-guided microcoil localization in 21 patients with solitary pulmonary nodules between May 2014 and April 2016. The lesion diameter was 7-21 (10.3±8.0) mm, and the distance from the visceral pleura was 5-23 (10.2±4.3) mm. CT-guided "trailing" technique was used for preoperative microcoil localization. Then VATS of pulmonary wedge resection was adopted. Pathological examination was conducted immediately after removal of pulmonary nodules. When malignant, VATS of lobectomy and mediastinal lymph node resection were performed.ResultsWe located 21 solitary pulmonary small nodules in 21 patients. All the lesions were successfully located by the microcoil. Asymptomatic pneumothorax was observed in 3 patients, none of which needed surgical treatment. Three microcoils were found displaced during VATS. The success rate of microcoil localization was 85.7% (18/21). Pathological diagnosis showed adenoearcinoma in situ (n=5), adenocarcinoma (n=11), atypical adenomatoid hyperplasia (n=1), inflammation (n=2), inflammatory pseudotumor (n=1), and metastatic adenocarcinoma (n=1).ConclusionPreoperative CT-guided microcoil localization for pulmonary small nodules is a simple, intuitive, effective and precise way to improve the accuracy of surgical resection, being worthy of promotion.

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备注/Memo

备注/Memo:
*通讯作者，E-mail:xujianxin8210@126.com①（北京大学人民医院胸外科胸部微创中心，北京100044）
更新日期/Last Update: 2017-06-20