[1]詹必成 刘建** 陈剑 周新涛 郭昆亮 刘永志 王欢.三维重建引导下胸腔镜扩大肺亚段切除术治疗肺段边缘结节[J].中国微创外科杂志,2021,01(10):904-907.
　Zhan Bicheng,Liu Jian,Chen Jian,et al.Threedimensional Reconstruction Guided Thoracoscopic Extended Subsegmentectomy for Nodules Located at the Edge of Segment[J].Chinese Journal of Minimally Invasive Surgery,2021,01(10):904-907.
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三维重建引导下胸腔镜扩大肺亚段切除术治疗肺段边缘结节()
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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10期
页码:
904-907
栏目:
临床研究
出版日期:
2021-10-25

文章信息/Info

Title:
Threedimensional Reconstruction Guided Thoracoscopic Extended Subsegmentectomy for Nodules Located at the Edge of Segment
作者:
詹必成 刘建** 陈剑 周新涛 郭昆亮 刘永志 王欢
(安徽医科大学附属安庆医院安庆市立医院心胸外科，安庆246003)
Author(s):
Zhan Bicheng;  Liu Jian;  Chen Jian;  et al.
Department of Cardiothoracic Surgery, Anqing Municipal Hospital, Anqing Hospital Affiliated to Anhui Medical University, Anqing 246003, China
关键词:
三维重建; 电视胸腔镜手术; 肺亚段切除术; 肺结节
Keywords:
Threedimensional reconstruction; Videoassisted thoracoscopic surgery; Subsegmentectomy; Pulmonary nodule
文献标志码:
A
摘要:
目的探讨三维重建引导下胸腔镜扩大肺亚段切除术治疗肺段边缘结节的临床效果。方法对2018年8月~2021年1月采用胸腔镜扩大肺亚段切除术治疗25例肺段边缘结节的临床资料进行回顾性分析。术前薄层CT扫描并进行三维重建。肺段边缘结节共26枚，纯磨玻璃结节17枚，混合性磨玻璃结节9枚，直径4~15(8.0±2.5)mm。其中8例术前Hookwire定位。采用膨胀-萎陷法确定段平面。结果25例扩大肺亚段切除术共切除肺结节26枚，其中1例中转小切口辅助手术，切缘宽度均>2 cm或不小于结节直径。手术时间80~270(121.8±36.8)min，术后胸腔引流时间2~7(3.5±1.3)d，术后住院4~15(6.0±2.2)d。术后肺部感染1例，痰中带血3例，其中1例漏气>3天，无围手术期死亡。结论三维重建引导下胸腔镜扩大肺亚段切除术治疗肺段边缘结节安全可行，能充分保证切缘，最大化保留正常肺组织。
Abstract:
ObjectiveTo analyze the safety of threedimensional (3D) reconstruction guided thoracoscopic extended subsegmentectomy (TESS) in the treatment of the nodules located at the edge of segment.MethodsWe retrospectively analyzed 25 patients with 26 nodules at the edge of segment who underwent TESS from August 2018 to January 2021. All the patients underwent thinslice CT scanning and 3D reconstruction preoperatively. Among the 26 nodules, 17 were pure ground glass nodules and 9 were mixed ground glass nodules, with a diameter of (8.0±2.5) mm (range, 4-15 mm). Eight patients were given CTguided hookwire localization preoperatively. The intersegmental plane was identified by inflationdeflation method.ResultsAll the 26 nodules were resected with TESS in the 25 patients. One patient was converted to open thoractomy with small incision. The surgical margin width was greater than 20 mm or not less than the size of the nodule. The operative time was (121.8±36.8) min (range, 80-270 min). The postoperative duration of chest tube placement was (3.5±1.3) d (range, 2-7 d), and the postoperative hospital stay was (6.0±22) d (range, 4-15 d). There were 1 patient with pulmonary infection and 3 patients with blood in sputum and one of them with air leakage over 3 days. No perioperative death was noted.Conclusion3D reconstruction guided TESS is a safe and feasible technique in the treatment of the nodules located at the edge of segment, which can ensure sufficient surgical margins and maximize the preservation of normal lung tissue.

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备注/Memo

备注/Memo:
基金项目：安徽医科大学校科研基金(2020xkj240)**通讯作者，Email：liujianaqslyy@126.com
更新日期/Last Update: 2022-02-08