[1]许德新 代祖建 林铿强＊ 陈树兴.氩气刀定位法在胸腔镜肺楔形切除手术中的应用[J].中国微创外科杂志,2018,18(11):1007-1010.
　Xu Dexin,Dai Zujian,Lin Kengqiang,et al.Application of Argon Knife Localization in the Operation of Thoracoscopic Wedge Resection[J].Chinese Journal of Minimally Invasive Surgery,2018,18(11):1007-1010.
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氩气刀定位法在胸腔镜肺楔形切除手术中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年11期
页码:
1007-1010
栏目:
临床研究
出版日期:
2018-11-20

文章信息/Info

Title:
Application of Argon Knife Localization in the Operation of Thoracoscopic Wedge Resection
作者:
许德新 代祖建 林铿强＊ 陈树兴
（福建省福州肺科医院胸外科，福州350004）
Author(s):
Xu Dexin;  Dai Zujian;  Lin Kengqiang;  et al.
Department of Thoracic Surgery, Fuzhou Pulmonary Hospital of Fujian Province, Fuzhou 350004, China
关键词:
氩气刀; 胸腔镜; 肺小结节; 定位
Keywords:
Argon knife; Thoracoscopy; Small pulmonary nodule; Localization
文献标志码:
A
摘要:
目的探讨氩气刀定位法在胸腔镜肺楔形切除手术中的应用价值。方法2015年1月~2018年1月，对63例肺部小结节(直径≤2 cm)采用氩气刀定位法实施单操作孔胸腔镜肺楔形切除术。病灶均为单发，最大径0.8~2 cm，（1.22±034）cm，均位于肺边缘，CT上测量病灶距离脏层胸膜0.5~3 cm，（1.67±0.54）cm。在CT上确定病灶的肋间层面及钟位方向，在胸腔镜下将病灶虚拟投影在壁层胸膜表面。氩气刀标记投影点，膨肺后再次喷射氩气，标记病灶在肺脏层胸膜表面的投影点，楔形切除病灶，根据冰冻病理结果决定下一步手术方案。结果61例（96.8％）在楔形切除标本中找到病灶，2例定位失败。行肺楔形切除53例，解剖性肺段切除2例，肺叶切除8例。术后病理证实肺癌58例，良性病变5例。结论氩气刀定位法对胸腔镜术中肺内小结节的定位实用、可靠，值得临床推广。
Abstract:
ObjectiveTo investigate the value of argon knife localization in the operation of thoracoscopic wedge resection.MethodsFrom January 2015 to January 2018, 63 cases of small pulmonary nodules (diameter ≤ 2 cm) were treated with argon knife localization for single utility port thoracoscopic wedge resection. The lesions were all solitary nodule located at the edge of the lung parenchyma, with a maximum diameter of 0.8-2 cm (mean, 1.22±0.34 cm). The distance from lesion site to the visceral pleura was measured with CT films, which ranged 0.5-3 cm (mean, 1.67±0.54 cm). The intercostal layer and the clock localization of the lesion were first determined on the CT, and then the lesion was virtually projected on the parietal pleural surface under thoracoscopy. The argon knife was used to mark the projection point. The argon gas was sprayed again after the lung reexpansion, and the projection point of the lesion on the surface of the pleural was marked. The lesions were then given a wedge resection. Following surgical plan was decided according to the frozen pathological results of the lesions.Results The lesions were located and found in wedge resection specimens in 61 cases (96.8%), while we failed to locate the lesions in 2 cases. A total of 53 patients underwent wedge resection, 2 underwent anatomical segmentectomy, and 8 underwent lobectomy. Postoperative pathology confirmed 58 cases of lung cancer and 5 cases of benign lesions.ConclusionArgon knife localization for small pulmonary nodules in the operation of thoracoscopic surgery is practical and reliable, and it is worthy of clinical promotion.

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更新日期/Last Update: 2019-03-01