肺小结节胸腔镜切除术前CT引导下带钩金属导丝锚定

发布时间：2018-04-22 11:36

本文选题：肺结节 + 电视辅助胸腔镜手术　；参考：《中国医学影像技术》2015年04期

【摘要】：目的探讨肺小结节胸腔镜切除术前CT引导下带钩金属导丝锚定操作方法及其临床应用价值。方法对28例恶性肿瘤患者共30枚肺小结节行CT引导下带钩金属导丝锚定辅助胸腔镜切除,评估结节定位的成功率、手术时间、并发症,分析其对患者肿瘤分期及疗效评价的影响。结果术前CT引导下带钩金属导丝定位平均手术时间为(15.0±3.2)min。28例患者(共30枚)肺小结节中,1例(1枚)患者术中见定位针脱落,行肺叶切除;另27例(29枚)结节均准确定位并行楔形肺切除。定位术后7例(7/28,25.00%)患者发生少量气胸,针道周围少量出血8例(8/27,29.63%),其中3例(3/28,10.71%)患者同时出现少量气胸和针道周围少量出血。术后病理证实15例(15/28,53.57%)肿瘤复发转移,1例(1/28,3.57%)患者为第二原发癌,12例(12/28,42.86%)患者因确诊为肺内良性结节确定肿瘤分期不变或疗效稳定。结论肺小结节胸腔镜切除术前CT引导下带钩金属导丝锚定操作便捷,成功率高,并发症少,对患者肿瘤准确分期及疗效评价有重要意义。
[Abstract]:Objective to investigate the operative method and clinical application of metal guide wire anchoring under CT guidance before thoracoscopic resection of small pulmonary nodules. Methods A total of 30 pulmonary nodules in 28 patients with malignant tumor were treated with CT-guided assisted thoracoscopic resection with metal guide wire anchor. The success rate, operative time and complications of nodule localization were evaluated. To analyze its effect on tumor staging and curative effect evaluation. Results the mean operative time of preoperative CT guided metal guide wire localization was 15.0 卤3.2)min.28 (30 pulmonary nodules), 1 case of small pulmonary nodules (1 case) was found to be exfoliated during operation, and the lobectomy was performed. In the other 27 cases, 29 nodules were accurately located and wedge pneumonectomy was performed. There were 7 cases of pneumothorax and 8 cases of hemorrhage around the needle path in 7 cases (7 / 28 25. 00%). Among them, 3 cases (3 / 28 / 10. 71) had a small amount of pneumothorax and a small amount of bleeding around the needle tract at the same time. Postoperative pathology confirmed that 15 cases (15 / 2853.57) tumor recurrence and metastasis (1 / 28 / 283.57) patients were second primary carcinoma 12 / 12 / 2842.86) patients were diagnosed as benign nodules in the lung to determine that the tumor stage was unchanged or the curative effect was stable. Conclusion before thoracoscopic resection of small pulmonary nodules, the anchoring with hook metal wire under the guidance of CT is convenient, the success rate is high, and the complications are few. It is of great significance for the accurate staging and evaluation of the curative effect of the tumor.
【作者单位】：北京大学肿瘤医院;北京市肿瘤防治研究所医学影像科;北京市肿瘤防治研究所胸部肿瘤外一科恶性肿瘤发病机制及转化研究教育部重点实验室;
【基金】：国家重点基础研究发展计划(973计划)项目(2011CB707705) 国家自然科学基金(81371715) 北京市科学技术委员会:首都特色临床应用研究(Z121107001012115)
【分类号】：R730.44;R734.2

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