CT引导弹簧圈定位在胸腔镜切除孤立肺结节的应用

The application of CT-guided localization with a embolization coil system in treatment of solitary pulmonary nodule with video-assisted thoracoscopic surgery

目的探讨CT引导弹簧圈术前定位在胸腔镜下切除孤立肺结节术中的临床应用价值。方法对2011年9月-2013年1月的孤立肺结节17例,术前先在CT引导下使用弹簧圈定位,然后在透视辅助胸腔镜下肺楔形切除孤立肺结节。统计弹簧圈定位成功率、定位时间、并发症、透视辅助胸腔镜下肺楔形切除病灶时间等。结果弹簧圈定位成功率100.0%,弹簧圈定位时间(18.40±5.30)min,无严重定位并发症,无症状并发症发生率58.9%(10例),其中气胸6例(35.3%)、局部肺组织出血3例(17.6%),同时发生气胸和局部肺组织出血1例(5.9%)。透视辅助胸腔镜下肺楔形切除病灶时间(15.71±4.25)min。结论孤立肺结节术前应用弹簧圈定位的准确率高,无严重并发症,弹簧圈很难出现移位脱落,方法简单易行、成本低、定位后透视下病灶位置容易辨认,是一种可行的术前定位方法。

Objective Video-agsisted thoracoscopic surgery（VATS） provides a minimally invasive approach to resect solitary pulmonary nodule（SPN）.The aim of this study is to evaluate the efficacy and safety of CT-guided localization with a embolization coil system in treatment of SPN with VATS.Methods From September 2011 to January 2013,17 patients with SPN underwent VATS wedge resection.On the day of the operation,under the guidance of CT,an embolization coil system was used to localize the SPN.Afterwards,the lesions were removed with VATS in the assistance of multi-angular fluoroscopy.The time of puncturing and surgery,achievement ratio,and the complications were summarized and analyzed.Results CT-guided localization with an embolization coil system successed in all patients（100%）.The time of puncturing was（18.40 ± 5.30） min.There was no serious complication.Asymptomatic complication rate was 58.9%.Among,pneumothorax rate,local pulmonary tissue hemorrhage rate and simultaneous pneumothorax and hemorrhage rate were 35.3%,17.6% and 5.9% respectively.Conclusion There are so many advantages of the application,such as high accuracy,no serious complications,simple,low cost,easily recognizable under fluoroscopy.It is a viable technique for SPN localization.