Hookwire定位下单孔胸腔镜切除孤立性肺小结节63例报告

A report of 63 cases of clinical experience on uniportal VATS resection of solitary pulmonary nodules under Hookwire localization

目的探讨Hookwire定位下单孔胸腔镜切除孤立性肺小结节的临床疗效。方法选取近期来我科收治的63例孤立性肺小结节患者作为观察对象,所有患者术前均在CT引导下留置Hookwire定位针,转至手术室在单孔胸腔镜下进行切除,并依据术中冰冻结果决定下一步手术方案。结果所有患者在CT引导下均成功行Hookwire定位,无严重定位并发症发生,转手术室均成功行单孔胸腔镜手术治疗,无中转开胸,均为一次性将结节切除。26例行VATS肺叶切除加淋巴结清扫术,术后石蜡病理结果与术中冰冻结果完全相符。结论孤立性肺小结节单孔胸腔镜手术前通过Hookwire穿刺定位,具有定位准确率高、疗效可靠、并发症少等特点,在临床上具有较高的应用价值。

Objective To explore the clinical efficacy of uniportal VATS resection of solitary pulmonary nodules under Hookwire localization.Methods Patients with solitary pulmonary nodules treated in our department were selected as observation objects.All patients underwent CT-guided placement of Hookwire positioning needles before surgery,and they were transferred to the operating room for resection under Uniportal VATS surgery.The results of the ice freeze determined the next surgical plan.Results All patients underwent Hookwire localization successfully under CT guidance.No serious localization complications occurred.All the patients were successfully treated with Uniportal VATS surgery in the operating room.None of the cases were transferred to open thoracotomy.26 patients underwent VATS lobectomy plus lymphadenectomy.Postoperative paraffin pathology results were completely consistent with intraoperative frozen results.Conclusion For patients with solitary pulmonary nodules,Hookwire puncture localization before uniportal VATS surgery has a high accuracy of positioning,reliable efficacy,less complications,and high practical value in clinical practice.