经纬法在胸腔镜肺小结节手术定位中的应用  

Clinical application of theodolitic method for locating small pulmonary nodules in video assisted thoracoscopic surgery

作　　者：张彤[1] 李云婧[1] 冯长江[1] 潘俊伊 马永富[1] 刘阳[1] ZHANG Tong;LI Yun-jing;FENG Chang-jiang;PAN Jun-yi;MA Yong-fu;LIU Yang(Department of Thoracic Surgery,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心胸外科

出　　处：《解放军医学杂志》2019年第12期1043-1046,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨经纬法定位肺小结节(SPN)在胸腔镜亚肺叶切除手术中的可行性及安全性。方法回顾性分析解放军总医院第一医学中心胸外科2017年3月—2019年4月行胸腔镜下亚肺叶切除术的146例患者的临床资料,其中男58例,女88例,年龄30~79岁。对手术时长、术中出血量、胸管留置时间、术后住院时间等进行统计学分析。结果经纬法判断准确度达96.6%(141/146)。146例实行了胸腔镜亚肺叶切除术,其中解剖性肺段切除术98例,楔形切除术48例,定位失败5例(3.4%)。术后病理类型如下:良性结节10例,鳞癌2例,黏液腺癌2例,腺癌132例。TNM分期均为T1N0M0。结论在胸腔镜亚肺叶切除术中应用经纬法定位SPN准确、有效且安全可行。Objective To investigate the feasibility and security of theodolitic method for locating small pulmonary nodule(SPN)in thoracoscopic subpulmonary lobectomy.Methods The clinical data of 146 cases,58 males and 88 females aged from 30 to 79,were retrospectively analyzed who underwent thoracoscopic subpulmonary lobectomy in the Department of Thoracic Surgery,the First Medical Center of Chinese PLA General Hospital from Mar.2017 to Apr.2019.The statistical analysis was performed for the operation time,intraoperative bleeding amount,time of chest tube retention and postoperative hospital stay,and so on.Results The accuracy of theodolitic method in judgment reached 96.6%(141/146).A hundred and forty-six cases were undergone thoracoscopic subpulmonary lobectomy,including 98 cases of anatomical pulmonary segmentectomy,48 cases of pulmonary wedge resection,and 5 cases(3.4%)of positioning failure.The postoperative pathological examination showed benign nodules in 10 cases,squamous cell carcinoma in 2 cases,mucinous adenocarcinoma in 2 cases,and adenocarcinoma in 132 cases.All the TNM staging were T1N0M0.Conclusion The theodolitic method has high accuracy,efficacy and safety for locating small pulmonary nodule in thoracoscopic subpulmonary lobectomy.

关 键 词：胸腔镜 肺段切除术 楔形切除术 精准外科 

分 类 号：R655.3[医药卫生—外科学]