[1]刘 丽,文 军,艾 敏,等.CT引导下弹簧圈联合亚甲蓝定位在周围型肺小结节电视胸腔镜手术中的应用 [J].介入放射学杂志,2018,27(12):1168-1172.
 LIU Li,WEN Jun,AI Min,et al.Application of CT- guided localization of peripheral pulmonary nodules with coil and methylene blue in performing video- assisted thoracoscopic surgery[J].journal interventional radiology,2018,27(12):1168-1172.
点击复制

CT引导下弹簧圈联合亚甲蓝定位在周围型肺小结节电视胸腔镜手术中的应用 
()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
27
期数:
2018年12期
页码:
1168-1172
栏目:
非血管介入
出版日期:
2018-12-25

文章信息/Info

Title:
Application of CT- guided localization of peripheral pulmonary nodules with coil and methylene blue in performing video- assisted thoracoscopic surgery
作者:
刘 丽 文 军 艾 敏 卢光明 申 翼 许 健
Author(s):
LIU Li WEN Jun AI Min LU Guangming SHEN Yi XU Jian.
Department of Medical Imaging, General Hospital of Eastern Theater Command, Clinical School, Medical College of Nanjing University, Nanjing, Jiangsu Province 210002, China
关键词:
【关键词】 周围型肺小结节 磨玻璃样肺结节 电视胸腔镜手术 弹簧圈 亚甲蓝
文献标志码:
A
摘要:
【摘要】 目的 探讨CT引导下血管栓塞用弹簧圈联合亚甲蓝术前定位在电视胸腔镜手术(VATS)周围型肺小结节楔形切除术中的临床应用价值,探讨周围型肺小结节积极微创手术治疗的临床可行性和必要性。方法 对36例周围型肺小结节患者在CT引导下经皮肺穿刺序贯植入血管栓塞用弹簧圈及亚甲蓝行VATS术前定位。VATS术中根据亚甲蓝及弹簧圈的位置来确定靶病灶的位置及手术切除范围,行VATS肺局部楔形切除。结果 36例患者行高分辨率CT扫描发现周围型肺小结节39个,VAST术前均成功植入39枚弹簧圈及亚甲蓝定位,定位术平均手术时间(11.3±1.45) min。定位后无严重并发症。所有病例均顺利行VAST切除术,平均手术时间(1.5±0.4) h,术后出现的并发症主要为感染(9例),经抗感染治疗后痊愈,无其他严重并发症发生。术后平均住院时间(3.25±0.52) d。术中快速病理及术后常规病理诊断一致。结论 CT引导下弹簧圈联合亚甲蓝在周围型肺小结节尤其是磨玻璃样结节VAST术中定位准确率高,并发症轻,具有较高的安全性及有效性,值得临床推广应用。

参考文献/References:

[1] Tomasetti C, Li L, Vogelstein B. Stem cell divisions, somatic mutations, cancer etiology, and cancer prevention[J]. Science, 2017, 355: 1330- 1334.
[2] Wahidi MM, Govert JA, Goudar RK, et al. Evidence for the treatment of patients with pulmonary nodules: when is it lung cancer? ACCP evidence- based clinical practice guidelines(2nd edition)[J]. Chest, 2007, 132(3 Suppl): 94S- 107S.
[3] Su TH, Fan YF, Jin L, et al. CT- guided localization of small pulmonary nodules using adjacent microcoil implantation prior to video- assisted thoracoscopic surgical resection[J]. Eur Radiol, 2015, 25: 2627- 2633.
[4] Ceppa DP, Kosinski AS, Berry MF, et al. Thoracoscopic lobectomy has increasing benefit in patients with poor pulmonary function: a Society of Thoracic Surgeons Database analysis[J]. Ann Surg, 2012, 256: 487- 493.
[5] Henschke CI, Yankelevitz DF, Mirtcheva R, et al. CT screening for lung cancer: frequency and significance of part- solid and nonsolid nodules[J]. AJR Am J Roentgenol, 2002, 178: 1053- 1057.
[6] Detterbeck FC, Homer RJ. Approach to the ground- glass nodule[J]. Clin Chest Med, 2011, 32: 799- 810.
[7] Takashima S, Maruyama Y, Hasegawa M, et al. CT findings and progression of small peripheral lung neoplasms having a replacement growth pattern[J]. AJR Am J Roentgenol, 2003, 180: 817- 826.
[8] Kim TJ, Goo JM, Lee KW, et al. Clinical, pathological and thin- section CT features of persistent multiple ground- glass opacity nodules: comparison with solitary ground- glass opacity nodule[J]. Lung Cancer, 2009, 64: 171- 178.
[9] Travis WD, Brambilla E, Noguchi M, et al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma[J]. J Thorac Oncol, 2011, 6: 244- 285.
[10] Zhou JH, Li WT, Chen HQ, et al. CT- guided hookwire localization of small solitary pulmonary nodules in video- assisted thoracoscopic surgery[J]. Zhonghua Zhong Liu Za Zhi, 2009, 31: 546- 549.
[11] Ichinose J, Kohno T, Fujimori S, et al. Efficacy and complications of computed tomography- guided hook wire localization[J]. Ann Thorac Surg, 2013, 96: 1203- 1208.
[12] Liu L, Zhang LJ, Chen B, et al. Novel CT- guided coil localization of peripheral pulmonary nodules prior to video- assisted thoracoscopic surgery: a pilot study[J]. Acta Radiol, 2014, 55: 699- 706.
[13] 刘 丽, 陈 波, 许 健, 等. CT和DSA复合引导下弹簧圈定位肺小结节胸腔镜切除术[J]. 介入放射学杂志, 2012, 21: 1002- 1006.
[14] Suzuki K, Koike T, Asakawa T, et al. A prospective radiological study of thin- section computed tomography to predict pathological noninvasiveness in peripheral clinical ⅠA lung cancer (Japan Clinical Oncology Group 0201)[J]. J Thorac Oncol, 2011, 6: 751- 756.
[15] Gu B, Burt BM, Merritt RE, et al. A dominant adenocarcinoma with multifocal ground glass lesions does not behave as advanced disease[J]. Ann Thorac Surg, 2013, 96: 411- 418.
[16] Chang B, Hwang JH, Choi YH, et al. Natural history of pure ground- glass opacity lung nodules detected by low- dose CT scan[J]. Chest, 2013, 143: 172- 178.
[17] Cho S, Yang H, Kim K, et al. Pathology and prognosis of persistent stable pure ground- glass opacity nodules after surgical resection[J]. Ann Thorac Surg, 2013, 96: 1190- 1195.

备注/Memo

备注/Memo:
(收稿日期:2018-03-06)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2018-12-20