背景:今天,肺结节的检出率越来越高。这些结节中的一些可能变成恶性。因此,及时切除潜在的恶性结节至关重要.然而,在手术期间识别非表面或软纹理结节的位置是具有挑战性的。已经开发了各种定位技术来准确地识别肺结节。常见的方法包括术前CT引导经皮放置钩丝和微线圈。尽管如此,这些手术可能会引起气胸和血胸等并发症。关于肺结节的定位的其他方法具有其自身的缺点。我们进行了一项临床研究,该研究是回顾性的,确定肺结节定位的准确和合适的方法。探讨CT辅助体表定位联合术中立体定向解剖定位在胸腔镜肺结节切除术中的临床应用价值。
方法:我们回顾性收集了在胸外科接受肺结节定位切除手术的120例患者的临床资料,蚌埠医学院第一附属医院,从2020年1月到2022年1月。其中,30例患者行CT辅助体表定位联合术中立体定向解剖定位,30例患者仅接受CT辅助体表定位,30例患者仅接受术中立体定向解剖定位,30例患者接受了CT引导下经皮微线圈定位。成功率,并发症发生率,并对四种肺结节定位方法的定位次数进行统计分析。
结果:CT辅助体表定位联合术中立体定向解剖定位和CT引导下经皮微弹簧圈定位的成功率均为96.7%,CT辅助体表定位组成功率70.0%,差异有统计学意义(P<0.05)。联合组并发症发生率为0%,显著低于微线圈定位组的60%(P<0.05)。联合组的定位时间为17.73±2.52min,显着小于微线圈定位组的(27.27±7.61min)(P<0.05)。
结论:CT辅助体表定位结合术中立体定向解剖定位是一种安全的,无痛,准确,肺结节定位的可靠方法。
BACKGROUND: Today, the detection rate of lung nodules is increasing. Some of these nodules may become malignant. Thus, timely resection of potentially malignant nodules is essential. However, Identifying the location of nonsurface or soft-textured nodules during surgery is challenging. Various localization techniques have been developed to accurately identify lung nodules. Common methods include preoperative CT-guided percutaneous placement of hook wires and microcoils. Nonetheless, these procedures may cause complications such as pneumothorax and haemothorax. Other methods regarding localization of pulmonary nodules have their own drawbacks. We conducted a clinical
study which was retrospective to identify a safe, accurate and suitable method for determining lung nodule localization. To evaluate the clinical value of CT-assisted body surface localization combined with intraoperative stereotactic anatomical localization in thoracoscopic lung nodule resection.
METHODS: We retrospectively collected the clinical data of 120 patients who underwent lung nodule localization and resection surgery at the Department of Thoracic Surgery, First Affiliated Hospital of Bengbu Medical College, from January 2020 to January 2022. Among them, 30 patients underwent CT-assisted body surface localization combined with intraoperative stereotactic anatomical localization, 30 patients underwent only CT-assisted body surface localization, 30 patients underwent only intraoperative stereotactic anatomical localization, and 30 patients underwent CT-guided percutaneous microcoil localization. The success rates, complication rates, and localization times of the four lung nodule localization methods were statistically analysed.
RESULTS: The success rates of CT-assisted body surface localization combined with intraoperative stereotactic anatomical localization and CT-guided percutaneous microcoil localization were both 96.7%, which were significantly higher than the 70.0% success rate in the CT-assisted body surface localization group (P < 0.05). The complication rate in the combined group was 0%, which was significantly lower than the 60% in the microcoil localization group (P < 0.05). The localization time for the combined group was 17.73 ± 2.52 min, which was significantly less than that (27.27 ± 7.61 min) for the microcoil localization group (P < 0.05).
CONCLUSIONS: CT-assisted body surface localization combined with intraoperative stereotactic anatomical localization is a safe, painless, accurate, and reliable method for lung nodule localization.