[Preoperative Computed Tomography-guided Microcoil Localization for Multiple Small Lung Nodules before Video-assisted Thoracoscopic Surgery].

• DOI: 10.3779/j.issn.1009-3419.2018.11.08
• Publication Date: 2018-11-20
• Authors: Fengwei Li; Yingtai Chen; Jianwei Bian; Xing Xin; Sijie Liu
• Keywords: Microcoil; Nodule (geology); Video-assisted thoracoscopic surgery; Solitary pulmonary nodule; Thoracoscopy; Thoracotomy; Cardiothoracic surgery

Localization of multiple small lung nodules is the technical difficulty minimally invasive operation resection. However, there are few clinical studies on preoperative localization nodules. This study was designed to evaluate value computed tomography (CT) guided microcoil for compared with single nodule before video-assisted thoracoscopic surgery (VATS).A retrospective analysis data 235 patients pulmonary performed. According whether were single, they divided into group (184 cases) and (51 (multiple group). The positioned under CT-guided conventional methods. CT localized by in batches according priority VATS. success rate, complications, pathological results operations related statistically analyzed.The rate groups 90.2%, no significant difference (90.2% vs 94.6%, P=0.205). occurrence pneumothorax statistical (21.6% 14.1%, P=0.179), however, time significantly longer than [(30.6±6.6) min (19.9±7.4) min, P=0.000]. There serious complications such as massive hemoptysis, air embolism or hemothorax. conversion thoracotomy due failure localizing during operation. Sub-lobectomy main method majority postoperative pathologies non-invasive carcinomas.For requiring surgery, certain strategies, VATS safe effective, worthy promotion.【中文题目：肺内多发小结节术前CT引导下微弹簧圈 定位的初步探讨】 【中文摘要：背景与目的 肺内多发小结节微创手术的成功与否有赖于术前定位，然而目前缺乏针对肺内多发小结节术前定位的临床研究。本研究旨在与同期肺内单发小结节定位相比，探讨行电视胸腔镜手术（video-assisted VATS）术前电子计算机断层扫描（computed tomography, CT）引导下留置微弹簧圈定位肺内多发小结节的临床价值。方法 回顾性分析术前行肺内小结节微弹簧圈定位者235例的临床资料。根据结节是否为单发分为：单发结节组184例（single group），多发结节组51例（multiple group）。单发结节组常规方式CT引导下定位，多发结节组在CT引导下分级、分批次留置微弹簧圈定位，统计分析两组定位成功率、并发症、病理结果及定位操作相关数据等。结果 多发结节组定位成功率达90.2%，与同期单发结节组成功率相比无统计学差异（90.2% P=0.205），多发结节组气胸发生率与单发结节组亦无统计学差异（21.6% P=0.179），然而多发结节组的操作时间明显长于单发结节组的操作时间［(30.6±6.6) P=0.000］。两组均无大咯血、空气栓塞及血胸发生等严重并发症。两组均无因术中无法定位结节而中转开胸者；手术方式以亚肺叶切除为主；术后病理以非浸润性病变为主。结论 对于需行胸腔镜手术的肺部多发小结节，按照一定策略，术前CT引导下分级、分批次留置微弹簧圈的定位方法安全、有效，值得推广。 】 【中文关键词：计算机断层扫描；定位；肺肿瘤；多发性；肺切除术】.