CT引导下新型定位器在胸腔镜肺小结节手术中的应用

Computed tomography-guided preoperative rigid-line hook-wire localization of small pulmonary nodules in video-assisted thoracoscopic surgery

目的:评估一次性肺结节定位针用于肺部微小结节及磨玻璃结节术前定位的安全性与有效性。方法:2020年7月1日~9月2日,在CT引导下行经皮穿刺软线爪钩定位肺小结节患者60例,所有患者随后行胸腔镜手术切除结节。结果:共定位结节63个。病变直径4~18mm,中位数8mm。其中实性结节3例、部分实性结节8例、纯磨玻璃结节52例。穿刺轻微并发症发生率为36.5%(23/63),其中无症状气胸21例、肺内血肿2例,均无需特殊处理。术中辅助定位成功率98.4%,切除率100%。结论:采用软线爪钩定位用于术前肺小结节及磨玻璃结节定位安全、有效、便捷。该技术门槛低、效果好,适合广泛推广。

Objective:To prospectively evaluate the efficiency,utility,practicality and results of pre-operative CT(computed tomography)-guided rigid-line hook-wire placement on localization of small nodules and ground glass opacities of the lungs.Methods:A total of 60 patients with 63 small pulmonary nodules underwent CTguided rigid-line hook wire localization consecutively between Jul.1 st,2020 and Sep.2 nd,2020.VATS(video-assisted thoracoscopic surgery)resection of lung tissue containing each pulmonary nodule was performed in the guidence of the rigid-line hook wire.Results:The rigid-line hook wire was performed successfully in all 63 small pulmonary nodules with a mean time of 9.63 min(5~17 min,SD 2.88 min),including 3 solid nodules,8 mixed ground glass opacities and 52 pure ground glass opacities,with an average diameter of 8 mm(4 ~18 mm).The complication rate of the localization was 36.5%(23/63),with 21 cases of asymptomatic pneumothorax and 2 cases of pulmonary hematoma.None of them required surgical intervention,nor severe complications occurred.The success rate of localization was 98.4% and the success rate of VATS removal was 100%.Conclusion:Preoperative localization of small pulmonary nodules using rigid-line single hook wire was found to be practical and safe.For its simplicity and convenience,it is fit for common hospitals.