肺局灶性磨玻璃影术前CT引导下金属粒子定位在VATS中的应用

Application of CT-guided Localization of Pulmonary Focal Ground Glass Opacity with Metal Particle in Performing Video-assisted Thoracoscopic Surgery

目的:评价CT引导下金属粒子术前定位在电视胸腔镜手术(VATS)肺局灶性磨玻璃影(GGO)切除术中的临床应用价值。方法:回顾性分析18例肺局灶性磨玻璃影患者应用CT引导下金属粒子植入行VATS术前定位的临床资料,VATS术中根据金属粒子的位置来确定靶病灶的位置及手术切除范围,行VATS肺局部楔形切除。结果:18例患者行高分辨率CT扫描发现肺局灶性磨玻璃影27个,VAST术前植入54枚金属粒子定位,1处发生脱落。定位术平均手术时间(26.1±2.9)min。定位后无严重并发症。所有病例均顺利行VAST切除术,平均手术时间(0.68±0.05)h,术后出现的并发症主要为感染(2例),经抗炎后治愈愈,无其他严重并发症。术后平均住院时间(5.0±0.4)d。术中快速病理及术后常规病理诊断一致。结论:CT引导下经皮穿刺置入金属粒子定位病灶安全、精准,提高了VATS手术成功率、可广泛应用该方法于临床胸腔镜手术术前定位。

Objective:To estimate the value diagnostic of CT-guided localization of pulmonary focal ground glass opacity(GGO) with metal particle in performing video-assisted thoracoscopic surgery(VATS).Methods:The clinical data of 18 patients with pulmonary focal ground glass opacity underwent CT guidedlocalization with metal particle in performing video-assisted thoracoscopic surgery were analyzed retrospectively,During the performance of VATS,the location of the target lesion andthe extent of lesion that required surgical removal were determined according to the metal particle,then VATS of pulmonary local wedge resection was carried out.Results:High-resolution CT scanwas employed in the 18 patients,and a total of 27 pulmonary focal ground glass opacities were detected.BeforeVATS,implantation of 54 metal particles were accomplished for all lesions,and a drop occurred in apulmonary focal ground glass opaciy.The average time spent for lesion locating was(26.1±2.9) minutes. No serious localization-relatedcomplications occurred. Successful VATS resection was achieved in all patients, the mean time spent onsurgery was(0.68±0.05) hours. The main postoperative complication was infection( n=2), which was cured afteranti-infective therapy. No other severe complications occurred. The average postoperative hospital stay was(5.0±0.4) days. Intraoperative rapid pathological diagnosis was highly consistent with postoperative routinepathological diagnosis.Conclusion:CT-guided percutaneous puncture with metal particles can locate the lesions safely and accurately, which improves the success rate of VATS and can be widely used in the preoperative localization of clinical thoracoscopic surgery.