CT引导下弹簧圈定位及X线透视下VATS切除亚厘米孤立性肺小结节的临床观察  

CT-guided coil localization and VATS resection under radioscopy for subcentimeter pulmonary nodules

作　　者：孙义军 许健[2] 易俊[3] 李德闽[3] 

机构地区：[1]宣城市人民医院心胸外科,安徽宣城242000 [2]南京大学医学院附属金陵医院南京军区南京总医院医学影像科,210002 [3]南京大学医学院附属金陵医院南京军区南京总医院心胸外科,210002

出　　处：《临床肿瘤学杂志》2015年第12期1136-1139,共4页Chinese Clinical Oncology

摘　　要：目的探讨CT引导下对直径小于10 mm孤立性肺部小结节（SPN）弹簧圈定位及同期X线透视下电视胸腔镜手术（VATS）切除的准确性及安全性。方法回顾性分析2014年3月至2015年4月收治的53例亚厘米SPN患者,采用CT引导下弹簧圈定位及在X线透视下进行VATS精准切除。结果 53例患者亚厘米SPN经CT定位后均经VATS准确切除,切除成功率为100%。CT引导下定位后出现气胸4例,局部肺组织出血2例,气胸合并出血1例。SPN切除后病理显示,恶性病变21例,其中原位高分化腺癌16例、微侵袭腺癌3例、转移癌2例;良性病变32例,其中慢性炎性肉芽肿12例、局灶性炎纤维化10例、不典型腺瘤样增生5例、硬化性血管瘤3例、肺错构瘤2例。术后肺部感染2例,经保守治疗治愈。术后住院时间3~7 d,平均住院时间为（4.11±1.03）d。结论 CT引导下弹簧圈定位和同期VATS切除是诊治亚厘米SPN较为准确和便捷的方法。Objective To investigate the accuracy and safety of preoperative CT-guided coil localization of subcentimeter solitary small pulmonary nodule（ SPN） and followed by video-assisted thoracic surgery（ VATS） resection under radioscopy. Methods From March 2014 to April 2015,53 patients with subcentimeter SPN underwent CT-guided coil localization of SPN and VATS resection under radioscopy were retrospectively reviewed. Results The SPNs were localized and resected with success rate of 100%. The complications associated with procedure included 4 pneumothorax,2 local parenchymal hemorrhage and 1 hemopneumothorax. Twenty-one nodules were confirmed as malignancies,including 16 well differentiated adenocarcinoma,3 minimally invasiveadenocarcinoma and 2metastatic lesions. Thirty-two nodules were confirmed as benign lesions,including 12 chronic granulomatous inflammation,10 inflammatory fibrosis,5 atypical adenomatous hyperplasia,3 sclerosing hemangioma,and 2 harmatoma. Two patients suffered from pulmonary infection,and recovered by conservative treatment. The postoperative hospital stay was 3-7 d,with average length of stay（ 4. 11 ±1. 03） d. Conclusion CT-guided coil localization followed by VATS resection under radioscopy can be an effective and safe procedure for accurate resection and diagnosis of subcentimeter pulmonary nodules.

关 键 词：亚厘米肺小结节 CT引导 弹簧圈 电视胸腔镜手术(VATS) 

分 类 号：R734.2[医药卫生—肿瘤]