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Abstract：
UNASSIGNED: Preoperative computed tomography (CT)-guided localization of small pulmonary nodules (SPNs) is the major approach for accurate intraoperative visualization in video-assisted thoracoscopic surgery (VATS). However, this interventional procedure has certain risks and may challenge to less experienced junior doctors. This study aims to evaluate the feasibility and efficacy of robotic-assisted CT-guided preoperative pulmonary nodules localization with the modified hook-wire needles before VATS.
UNASSIGNED: A total of 599 patients with 654 SPNs who preoperatively accepted robotic-assisted CT-guided percutaneous pulmonary localization were respectively enrolled and compared to 90 patients with 94 SPNs who underwent the conventional CT-guided manual localization. The clinical and imaging data including patients\' basic information, pulmonary nodule features, location procedure findings, and operation time were analyzed.
UNASSIGNED: The localization success rate was 96.64% (632/654). The mean time required for marking was 22.85±10.27 min. Anchor of dislodgement occurred in 2 cases (0.31%). Localization-related complications included pneumothorax in 163 cases (27.21%), parenchymal hemorrhage in 222 cases (33.94%), pleural reaction in 3 cases (0.50%), and intercostal vascular hemorrhage in 5 cases (0.83%). Localization and VATS were performed within 24 hours. All devices were successfully retrieved in VATS. Histopathological examination revealed 166 (25.38%) benign nodules and 488 (74.62%) malignant nodules. For patients who received localizations, VATS spent a significantly shorter time, especially the segmentectomy group (93.61±35.72 vs. 167.50±40.70 min, P<0.001). The proportion of pneumothorax in the robotic-assisted group significantly decreased compared with the conventional manual group (27.21% vs. 43.33%, P=0.002).
UNASSIGNED: Robotic-assisted CT-guided percutaneous pulmonary nodules hook-wire localization could be effectively helpful for junior less experienced interventional physicians to master the procedure and potentially increase precision.
UNASSIGNED: A total of 599 patients with 654 SPNs who preoperatively accepted robotic-assisted CT-guided percutaneous pulmonary localization were respectively enrolled and compared to 90 patients with 94 SPNs who underwent the conventional CT-guided manual localization. The clinical and imaging data including patients\' basic information, pulmonary nodule features, location procedure findings, and operation time were analyzed.
UNASSIGNED: The localization success rate was 96.64% (632/654). The mean time required for marking was 22.85±10.27 min. Anchor of dislodgement occurred in 2 cases (0.31%). Localization-related complications included pneumothorax in 163 cases (27.21%), parenchymal hemorrhage in 222 cases (33.94%), pleural reaction in 3 cases (0.50%), and intercostal vascular hemorrhage in 5 cases (0.83%). Localization and VATS were performed within 24 hours. All devices were successfully retrieved in VATS. Histopathological examination revealed 166 (25.38%) benign nodules and 488 (74.62%) malignant nodules. For patients who received localizations, VATS spent a significantly shorter time, especially the segmentectomy group (93.61±35.72 vs. 167.50±40.70 min, P<0.001). The proportion of pneumothorax in the robotic-assisted group significantly decreased compared with the conventional manual group (27.21% vs. 43.33%, P=0.002).
UNASSIGNED: Robotic-assisted CT-guided percutaneous pulmonary nodules hook-wire localization could be effectively helpful for junior less experienced interventional physicians to master the procedure and potentially increase precision.
摘要：
■术前计算机断层扫描（CT）引导的肺小结节（SPN）定位是电视胸腔镜手术（VATS）术中准确可视化的主要方法。然而,这种介入手术有一定的风险，可能会对经验不足的初级医生构成挑战。本研究旨在评估机器人辅助CT引导下在VATS术前使用改良钩针定位肺结节的可行性和有效性。
■共纳入599例术前接受机器人辅助CT引导经皮肺定位的654例SPN患者，并与90例接受常规CT引导手动定位的94例SPN患者进行比较。包括患者基本信息在内的临床和影像学资料,肺结节特征，定位程序发现，并对手术时间进行了分析。
■定位成功率为96.64％（632/654）。标记所需的平均时间为22.85±10.27分钟。锚定移位2例(0.31%)。局部相关并发症包括气胸163例（27.21%），222例（33.94%），胸膜反应3例（0.50％），肋间血管出血5例(0.83%)。在24小时内进行定位和VATS。已在VATS中成功检索所有设备。组织病理学检查发现166个（25.38％）良性结节和488个（74.62％）恶性结节。对于接受定位的患者，VATS花费的时间明显更短，尤其是节段切除术组(93.61±35.72vs.167.50±40.70min,P<0.001)。与传统手动组相比，机器人辅助组的气胸比例明显降低（27.21%vs.43.33%,P=0.002)。
■机器人辅助CT引导下经皮肺结节钩丝定位可有效帮助初级经验不足的介入医师掌握手术，并有可能提高精确度。
■共纳入599例术前接受机器人辅助CT引导经皮肺定位的654例SPN患者，并与90例接受常规CT引导手动定位的94例SPN患者进行比较。包括患者基本信息在内的临床和影像学资料,肺结节特征，定位程序发现，并对手术时间进行了分析。
■定位成功率为96.64％（632/654）。标记所需的平均时间为22.85±10.27分钟。锚定移位2例(0.31%)。局部相关并发症包括气胸163例（27.21%），222例（33.94%），胸膜反应3例（0.50％），肋间血管出血5例(0.83%)。在24小时内进行定位和VATS。已在VATS中成功检索所有设备。组织病理学检查发现166个（25.38％）良性结节和488个（74.62％）恶性结节。对于接受定位的患者，VATS花费的时间明显更短，尤其是节段切除术组(93.61±35.72vs.167.50±40.70min,P<0.001)。与传统手动组相比，机器人辅助组的气胸比例明显降低（27.21%vs.43.33%,P=0.002)。
■机器人辅助CT引导下经皮肺结节钩丝定位可有效帮助初级经验不足的介入医师掌握手术，并有可能提高精确度。
