微弹簧圈定位在胸腔镜肺小结节切除术中的应用

发布时间：2018-04-15 20:03

本文选题：肺小结节 + 微弹簧圈定位　；参考：《中国微创外科杂志》2017年03期

【摘要】：目的探讨术前CT引导下微弹簧圈定位在胸腔镜孤立性肺小结节切除术中的应用价值。方法 2014年5月~2016年4月,对21例单发肺部小结节病灶经术前定位后行胸腔镜手术切除。结节直径7~21(10.3±8.0)mm,距离脏层胸膜深度5~23(10.2±4.3)mm。术前1日在CT引导下行"拖尾法"微弹簧圈术前定位,胸腔镜下行病灶楔形切除术,送冰冻病理,如为恶性继续行胸腔镜下肺叶切除加纵隔淋巴结清扫术。结果全组21例肺小结节均成功经皮肺穿刺置入微弹簧圈。定位并发症为无症状气胸3例,均无需处理。胸腔镜术中发现微弹簧圈脱位3例,定位成功率85.7%(18/21)。21例均行胸腔镜手术切除。病理确诊原位癌5例,腺癌11例,非典型腺瘤样增生1例,炎症2例,炎性假瘤1例,肺内转移瘤1例。结论 CT引导下微弹簧圈定位用于肺内小结节术前定位是一种简单、直观、有效、精确的方法,值得推广。
[Abstract]:Objective to evaluate the value of preoperative CT guided microcoils localization in thoracoscopic solitary pulmonary nodule resection.Methods from May 2014 to April 2016, 21 patients with single pulmonary nodules underwent thoracoscopic resection after preoperative localization.The diameter of the nodules was 7: 21 卤8. 3 卤8. 0 mm, and the depth of the visceral pleura was 5 23. 2 卤4. 3 mm..On the 1st day before operation, the "trailing method" microcoils were located before operation under the guidance of CT, and the focus wedge resection was performed under thoracoscopy, and the frozen pathology was sent, such as continuing thoracoscopic lobectomy and mediastinal lymph node dissection for malignant cases.Results all 21 cases of pulmonary nodules were successfully implanted with microcoils through pulmonary puncture.The localization complication was asymptomatic pneumothorax in 3 cases.Three cases of dislocation of microcoils were found during thoracoscopic operation, and the success rate of localization was 85.7% 21 cases. All cases underwent thoracoscopic resection.Pathological diagnosis included 5 cases of carcinoma in situ, 11 cases of adenocarcinoma, 1 case of atypical adenomatous hyperplasia, 2 cases of inflammation, 1 case of inflammatory pseudotumor and 1 case of intrapulmonary metastasis.Conclusion CT guided microcoil localization is a simple, intuitive, effective and accurate method for preoperative localization of small pulmonary nodules, and it is worth popularizing.
【作者单位】：福建医科大学教学医院莆田市第一医院胸外科;北京大学人民医院胸外科胸部微创中心;
【分类号】：R655.3

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