[1]文爽* 刘阳 张冉① 袁庆锋① 石长林① 张琪① 周黎 岳孟超.带线锚钩在CT引导下肺磨玻璃结节术前定位中的应用[J].中国微创外科杂志,2021,01(4):323-327.
　Wen Shuang*,Liu Yang*,Zhang Ran,et al.Application of Anchor Claw and Suture System in CTguided Preoperative Localization of Pulmonary Groundglass Nodules[J].Chinese Journal of Minimally Invasive Surgery,2021,01(4):323-327.
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带线锚钩在CT引导下肺磨玻璃结节术前定位中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年4期
页码:
323-327
栏目:
临床研究
出版日期:
2021-04-25

文章信息/Info

Title:
Application of Anchor Claw and Suture System in CTguided Preoperative Localization of Pulmonary Groundglass Nodules
作者:
文爽* 刘阳 张冉① 袁庆锋① 石长林① 张琪① 周黎 岳孟超
(四川省巴中市中心医院放射影像科，巴中636000)
Author(s):
Wen Shuang*;  Liu Yang*;  Zhang Ran;  et al.
*Department of Radiology, Bazhong Central Hospital, Bazhong 636000, China
关键词:
CT引导; 磨玻璃结节; 带线锚钩; 术前定位; 胸腔镜手术
Keywords:
CT guided; Groundglass nodule; Anchor claw and suture system; Preoperative localization; Videoassisted thoracoscopic surgery
文献标志码:
A
摘要:
目的探讨带线锚钩在CT引导下肺磨玻璃结节（groundglass nodule，GGN）术前定位中的临床应用价值。方法2019年6月~2020年8月，采用由四爪锚钩和三色标记刻度缝线组成的带线锚钩系统，对35例肺GGN在CT引导下经皮穿刺植入带线锚钩行术前定位，24 h内行胸腔镜手术（videoassisted thoracoscopic surgery，VATS），根据裸露于胸膜腔的三色线尾段及其标示的刻度，判断肺内锚钩和病灶的位置，以确定手术切除范围，行肺局部楔形切除术。结果35例GGN均完成CT引导下带线锚钩术前定位，植入后CT检查示所有锚钩均位于距病灶边缘1 cm范围内，定位操作时间（11.7±4.3）min，定位术后气胸、肺出血、短暂性胸痛发生率分别为11.4%（4/35）、11.4%（4/35）、2.9%（1/35），均无严重并发症。定位与手术间隔时间1~23 h（中位时间16 h）。术中见34例（97.1%）三色线尾段位于脏层胸膜外，另1例三色线全部留置于肺内，通过触诊肺内锚钩确定病灶位置。35例均成功行VATS肺楔形切除术，并获得病理诊断。结论使用带线锚钩进行CT引导下肺磨玻璃结节术前定位安全有效，操作方便，值得临床推广应用。
Abstract:
ObjectiveTo evaluate the clinical application of anchor claw and suture system in CTguided preoperative localization of pulmonary groundglass nodules (GGN).MethodsBetween June 2019 and August 2020, CTguided percutaneous pulmonary puncture with implantation of anchor claw and suture system, which had anchor claw with 4 fishhookshaped hooks and a tricolored marking scale suture, to make preoperative localization of GGN was performed in 35 patients. Videoassisted thoracoscopic surgery (VATS) was performed within 24 hours after localization. During the performance of VATS, the position of anchor claw and target lesion was determined according to the tail segment of tricolor suture exposed in pleural cavity and its marked scale, so as to determine the scope of surgical resection, and then pulmonary local wedge resection was carried out.ResultsThe CTguided anchor claw and suture implantations targeting 35 GGN were performed. After implantation, CT scan showed that all the anchor claws were located within 1 cm from the edge of the target lesion. The time spent for making localization was (11.7±4.3) min. After puncture localization, the incidence of pneumothorax, pulmonary hemorrhage and transient chest pain were 11.4% (4/35), 11.4% (4/35) and 2.9% (1/35), respectively. No serious localizationrelated complications occurred. The time interval between surgery and localization was 1-23 h (median, 16 h). During the surgery, 34 cases (97.1%) showed that the tail of tricolor suture was exposed outside the pleura of lung layer. In another case, the whole tricolor suture was placed in the lung, and the location of the lesion was determined by palpating the anchor claw in the lung. In all the patients, the target lesion was successfully wedge resected by VATS and the correct diagnosis was obtained.ConclusionCT guided preoperative localization of pulmonary groundglass nodules with anchor claw and suture system is safe, effective and convenient to operate, which is worthy of clinical application.

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备注/Memo

备注/Memo:
*通讯作者，Email：bzchws@163.com ①胸外科
更新日期/Last Update: 2021-06-30