CT引导下穿刺活检联合相同针道微波消融治疗肺癌术后同侧单发恶性倾向肺结节

CT-guided percutaneous biopsy followed by coaxial microwave ablation for new-onset solitary pulmornary nodule with malignant tendency on the same side of lung cancer after surgical resection

目的观察CT引导下穿刺活检联合相同针道微波消融治疗肺癌术后同侧单发恶性倾向肺结节的有效性及安全性。方法将56例(56枚结节)肺癌术后同侧单发恶性倾向肺结节患者随机分为观察组和对照组,每组28例。对观察组于CT引导下穿刺活检后经同轴套管同针道行微波消融,对照组于CT引导下穿刺活检后经异穿刺点交叉针道行微波消融,对比2组疗效及并发症。结果2组穿刺活检和微波消融操作成功率、总有效率及局部控制率均为100%。术后24 h内,观察组气胸、咯血及胸腔积液发生率分别为17.86%(5/28)、7.14%(2/28)和7.14%(2/28),对照组分别为21.43%(6/28)、7.14%(2/28)和10.71%(3/28),组间差异均无统计学意义(P均>0.05)。随访6个月,2组均未见针道种植转移、肺栓塞及支气管胸膜瘘等并发症。结论CT引导下穿刺活检联合相同针道微波消融治疗肺癌术后同侧单发恶性倾向肺结节效果确切,安全性较好。

Objective To observe the efficacy and safety of CT-guided simultaneous percutaneous core needle biopsy and microwave ablation via coaxial cannula for treatment of solitary pulmonary nodule with malignant tendency occurred on the same side of lung cancer after surgical resection.Methods A total of 56 patients with solitary pulmonary nodule with malignant tendency on the same side of lung cancer after surgical resection were enrolled and randomly divided into study group and control group(each n=28).Patients in study group underwent microwave ablation through the same needle channel after coaxial cannula puncture and biopsy,while those in control group underwent microwave ablation through the cross needle channel at different puncture points after biopsy.The effects and complications were compared between groups.Results The success rate of puncture biopsy and microwave ablation,total effective rate and local control rate were all 100%in 2 groups.Within 24 h after operation,the incidence of pneumothorax,hemoptysis and pleural effusion in study group was 17.86%(5/28),7.14%(2/28)and 7.14%(2/28),respectively,while in control group was 21.43%(6/28),7.14%(2/28)and 10.71%(3/28),respectively.There was no statistical significance between groups(all P>0.05).During 6 months'follow-up,no complication such as needle implant metastasis,pulmonary embolism nor bronchopleural fistula was found in both groups.Conclusion CT-guided simultaneous percutaneous core needle biopsy and microwave ablation via coaxial cannula was effective and safe for treatment of solitary pulmonary nodule with malignant tendency occurred on the same side of lung cancer after surgical resection.