CT引导带钩钢丝定位在肺小结节胸腔镜切除术中的应用

CT-guided preoperative hookwire localization of lung nodule in video-assisted thoracic surgery

目的：探讨胸腔镜手术前使用CT引导带钩钢丝定位，确定肺部小结节位置，以利于手术中切除的疗效与安全性。方法：收集自2012年2月至2014年3月天津医科大学肿瘤医院住院34例患者，术前使用CT引导下带钩钢丝（hookwire）定位肺部小结节，定位完成后直接行胸腔镜下肺部病变切除，根据术中冰冻病理结果决定下一步术式。结果：肺部小结节直径5～22 mm。采用CT引导下hookwire定位成功率100%，中位定位时间23 min。2例患者在操作过程中穿刺针脱落，有3例患者定位后CT扫描时发现气胸。结论：术前使用CT引导下带钩钢丝定位肺部微小病变的方法准确、安全性高，能够提高胸腔镜手术中肺部结节切除的准确率。

Objective：To explore the feasibility and safety of CT-guided hookwire localization of small lung nodule in video-as-sisted thoracic surgery. Methods： Preoperative localization of small lung nodule was performed using the CT-guided hookwire tech-nique, followed by video-assisted thoracic surgery in the wedge resection. The next mode of operation depends on the results of frozen biopsy. Results：Preoperative localization with CT-guided hookwire was performed in 34 patients between February 2012 and March 2014. The diameter of lung nodule ranged from 5 mm to 22 mm. CT-guided hookwire localization was successful in all patients, with a median positioning time of 23 min. Puncture needles were detached from two of the total patients during the surgery, and three other pa-tients showed pneumothorax by CT scan after localization. Conclusion：Preoperative hookwire localization of small lung nodule is an accurate and safe approach to improve the rate of wedge resection in video-assisted thoracic surgery.