[1]张楠 陈树兴 林铿强 陈新富 许添辉 陈星**.基于“流域分析”的解剖性部分肺切除术在早期周围型肺癌中的应用[J].中国微创外科杂志,2023,01(1):20-24.
　Zhang Nan,Chen Shuxing,Lin Kengqiang,et al.Application of the Anatomical Partial Lobectomy Based on “Watershed Analysis” in the Treatment of Earlystage Peripheral Lung Cancer[J].Chinese Journal of Minimally Invasive Surgery,2023,01(1):20-24.
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基于“流域分析”的解剖性部分肺切除术在早期周围型肺癌中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2023年1期
页码:
20-24
栏目:
临床研究
出版日期:
2023-01-25

文章信息/Info

Title:
Application of the Anatomical Partial Lobectomy Based on “Watershed Analysis” in the Treatment of Earlystage Peripheral Lung Cancer
作者:
张楠 陈树兴 林铿强 陈新富 许添辉 陈星**
(福建省福州肺科医院胸外科，福州350000)
Author(s):
Zhang Nan;  Chen Shuxing;  Lin Kengqiang;  et al.
Department of Thoracic Surgery, Fuzhou Pulmonary Hospital of Fujian, Fuzhou 350000, China
关键词:
流域分析; 解剖性部分肺切除术; 早期周围型肺癌
Keywords:
Watershed analysis; Anatomical partial lobectomy; Earlystage peripheral lung cancer
文献标志码:
A
摘要:
目的探讨基于“流域分析”的解剖性部分肺切除术在早期周围型肺癌治疗中的可行性。方法回顾性分析2021年9月~2022年3月单治疗组23例胸腔镜下解剖性部分肺切除术资料。术前行三维重建，明确结节所在流域的动脉及切除范围，行单操作孔胸腔镜手术，离断靶动脉，无需处理支气管，然后行荧光反染，切除肺实质。结果23例均顺利完成手术，无扩大切除，无中转肺叶切除。手术时间(138.4±35.0)min，术中出血量(30.0±19.7)ml，术后引流时间(2.3±0.9)d，术后住院时间(4.6±1.4)d，肿瘤最大直径(1.0±0.3)cm。切除淋巴结(3.2±1.3)枚，均未见肿瘤转移。术后并发症3例，无死亡。结论基于“流域分析”的解剖性部分肺切除术对于早期周围型肺癌的切除安全、可行。
Abstract:
ObjectiveTo investigate the feasibility of the anatomical partial lobectomy based on “watershed analysis” in the treatment of earlystage peripheral lung cancer.MethodsClinical data of 23 patients with earlystage peripheral lung cancer who underwent anatomical partial lobectomy based on “watershed analysis” between September 2021 and March 2022 were retrospectively reviewed. Before operation, threedimensional reconstruction was performed to identify the arteries in the range where the nodule was located and the scope of resection. The single utility port videoassisted thoracic surgery was performed. The target pulmonary artery was cut while preserving segmental bronchus, then a wedge resection was performed with indocyanine green fluorescence negative staining.ResultsAll the patients underwent basal segmentectomy successfully with no conversion to multiportal procedure or thoracotomy. The average operation time was (138.4±35.0) min, the average intraoperative blood loss was (30.0±19.7) ml, the average drainage time was (2.3±0.9) d, and the average postoperative hospital stay was (4.6±1.4) d. The average maximum diameter of the lesion in the resected basal segment was (1.0±0.3) cm. The average number of resected lymph nodes was (3.2±13). There was no evidence of nodal metastases. Three patient suffered postoperative complications. No perioperative death occurred.ConclusionThe anatomical partial lobectomy based on “watershed analysis” in the treatment of earlystage peripheral lung cancer is safe and feasible.

参考文献/References:

[1]Kuhn E,Morbini P,Cancellieri A,et al.Adenocarcinoma classification patterns and prognosis.Pathologica,2018,110(1):5-11.
[2]Chu XP,Chen ZH,Lin SM,et al.Watershed analysis of the target pulmonary artery for realtime localization of nonpalpable pulmonary nodules.Transl Lung Cancer Res,2021,10(4):1711-1719.
[3]王宗凯，葛明建.亚肺叶切除术治疗早期非小细胞肺癌时肺切缘的研究进展.中国肺癌杂志，2018，21(6):498-502.
[4]姜格宁,陈昶,朱余明,等.上海市肺科医院磨玻璃结节早期肺腺癌的诊疗共识(第一版).中国肺癌杂志,2018,21(3):147-159.
[5]Suzuki K,Watanabe SI,Wakabayashi M,et al.A singlearm study of sublobar resection for groundglass opacity dominant peripheral lung cancer.J Thorac Cardiovasc Surg,2022,163:289-301.
[6]Aokage K,Yoshida J,Hishida T,et al.Limited resection for earlystage nonsmall cell lung cancer as functionpreserving radical surgery:a review.Jpn J Clin Oncol,2017,47(1):7-11．
[7]Saji H,Okada M,Tsuboi M,et al.Segmentectomy versus lobectomy in smallsized peripheral nonsmallcell lung cancer (JCOG0802/WJOG4607L):a multicentre,openlabel,phase 3,randomised,controlled,noninferiority trial.Lancet,2022,399(10335):1607-1617.
[8]邱斌,冀瑛,白广宇，等.解剖性部分肺叶切除术治疗早期肺癌:实践与发展.中华胸部外科电子杂志，2020，(4):240-246.
[9]于雷,赵庆涛,王志康,等.术中冰冻病理对肺结节胸腔镜手术切除范围的指导意义.中国微创外科杂志,2020,20(3):230-233.
[10]Sarsam M,Glorion M,de Wolf J,et al.The role of threedimensional reconstructions in understanding the intersegmental plane:an anatomical study of segment 6.Eur J Cardiothorac Surg,2020,58(4):763-767.

备注/Memo

备注/Memo:
基金项目：福建省青年基金项目(2021QNA066)；福州市重点专科项目(201912003)**通讯作者，Email：32780635@qq.com
更新日期/Last Update: 2023-04-23