胸腔镜肺段切除术诊治磨玻璃结节的效果

Thoracoscopic segmentectomy for diagnosis and treatment of ground glass nodules

目的分析三维重建指导胸腔镜肺段切除术诊治磨玻璃结节(GGN)的效果。方法回顾性分析2020年10月至2021年6月于北京大学国际医院接受三维重建指导胸腔镜肺段切除术9例GGN患者临床资料。结果9例患者均顺利完成三维重建指导胸腔镜肺段切除术,其中,右肺上叶2例,右肺下叶1例,左肺上叶5例,左肺下叶1例,无中转开胸,R0切除率为100%。手术时间(377.89±115.96)min,术中出血为(150.00±96.82)ml。术后最高视觉模拟评分法(VAS)评分为(3.67±0.71)分,术后引流时间(6.33±2.39)d,术后引流总量(1278.89±511.23)ml,术后住院时间(8.78±2.68)d。术后引流时间>7 d者1例(11.11%),拔管延迟原因为肺漏气。9例患者均出现术后并发症,其中,1级4例,2级5例,无3~5级严重并发症或围术期死亡。清扫淋巴结3~6组[(4.89±1.05)组],清扫淋巴结11~20个[(14.00±2.73)个]。结论三维重建指导胸腔镜肺段切除术诊治GGN安全有效。

Objective To analyze the role of three-dimensional reconstruction guided thoracoscopic segmentectomy in the diagnosis and treatment of ground glass nodules(GGN).Methods The clinical data of nine patients with GGN who underwent three-dimensional reconstruction guided thoracoscopic segmentectomy at the Peking University International Hospital from October 2020 to June 2021 were retrospectively analyzed.Results All the nine patients successfully underwent three-dimensional reconstruction guided thoracoscopic segmentectomy.The nodules were located in the right superior lobe in two patients,in the right inferior lobe in one patient,in the left superior lobe in five patients,and in the left inferior lobe in one patient.There was no conversion to thoracotomy,and the rate of R0 resection was 100%(9/9).The operation time was(377.89±115.96)min,and the intra-operative bleeding loss was(150.00±96.82)ml.The duration of postoperative drainage was(6.33±2.39)d,the total amount of postoperative thoracic drainage was(1278.89±511.23)ml,and the duration of postoperative hospitalization was(8.78±2.68)d.There was one(11.11%)patient whose postoperative thoracic drainage time was>7 d,and the main cause of delayed extubation was prolonged lung air leakage.All the nine patients had postoperative complications,including four with grade 1 complications and five with grade 2 complications;no grades 3-5 complications or perioperative death occurred.The number of groups of dissected lymph nodes was 3-6[(4.89±1.05)],and the total number of dissected lymph nodes was 11-20[(14.00±2.73)].Conclusion Three-dimensional reconstruction guided thoracoscopic segmentectomy is safe and effective in the diagnosis and treatment of GGN.