CT引导钢丝定位下单孔胸腔镜手术治疗肺孤立性结节  

CT-guided localization single port video-assisted thoracic surgery for patients with solitary pulmonary nodule

作　　者：倪达[1] 杨志胤[1] 朱余明[2] 滕继平[1] 程佑爽[1] 朱智军[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院胸外科,上海201900 [2]同济大学附属上海市肺科医院胸外科,上海200433

出　　处：《海南医学》2015年第9期1351-1353,共3页Hainan Medical Journal

摘　　要：目的探讨CT引导钢丝定位下单孔胸腔镜手术对肺孤立性结节的诊疗价值。方法回顾性分析2012年2月至2014年3月上海交通大学医学院附属第三人民医院胸外科收治的SPN患者86例,CT引导下留置带钩钢丝,沿钢丝定位处行单孔胸腔镜肺楔形切除(单孔组),根据术中冰冻病理结果决定进一步手术方式。用同期胸腔镜辅助小切口治疗74例SPN患者做对照(小切口组),比较两组患者的手术时间、术中出血量、拔除胸腔引流管时间、术后住院时间及术后并发症等。结果单孔组在手术时间、手术出血量、拔除胸引管时间与小切口组比较差异均有统计学意义(P<0.05),但两组在术后并发症及住院时间等指标方面比较差异均无统计学意义(P>0.05)。结论采用CT引导钢丝定位下单孔胸腔镜手术治疗SPN,手术创伤小,疗效可靠,具有很好的临床推广价值。Objective To evaluate clinical outcomes of CT-guided localization single port video-assisted tho- racic surgery （VATS） for patients with solitary pulmonary nodule （SPN）. Methods Eighty-six patients with SPN who underwent CT-guided localization single port VATS from February 2012 to March 2014 in Shanghai Third People＇s Hospi- tal, Shanghai Jiao Tong University School of Medicine were enrolled as the single port group. Hookwire localization pins were retained guided by CT scan into the patients＇ body, and single port VATS pulmonary wedge resection was adopted. Ac- cording to the results of intraoperative frozen pathology, further treatment method was decided. Another 74 patients with SPN who underwent video-assisted mini-thoracotomy （VAMT） in the same period were selected as mini-thoraeotomy group. The clinical outcomes, including operation lime, intraoperative blood loss, chest drainage duration, postoperative hospitalization time and postoperative complications, were compared between the two groups. Results There were statis- tical differences in the operation time, intmope^ative blood loss, and chest drainage duration between the two groups （P〈 0.05）. There were no statistical differences in postoperative hospitalization time and postoperative complications between the two groups （P〉0.05）. Conclusion CT-guided localization single port VATS has less injury, reliable curative effect in treatment of SPN, which possesses great value in clinical promotion.

关 键 词：胸腔镜 肺孤立性结节 单孔 CT引导定位 

分 类 号：R445[医药卫生—影像医学与核医学]