电磁导航支气管镜引导下注入荧光剂在肺结节定位切除术中可行性  

Feasibility of injecting Fluorescent Agent under the Guidance of Electromagnetic Navigation Bronchoscopy in Pulmonary Nodule Resection

作　　者：王功铭 林勇斌[1] 罗孔嘉[1] 林晓丹 张兰军[1] Gongming WANG;Yongbin LIN;Kongjia LUO;Xiaodan LIN;Lanjun ZHANG(Department of Thoracic Surgery of Sun Yat-sen University Cancer Center,Guangzhou 510060,China)

机构地区：[1]中山大学肿瘤防治中心胸外科,广州510060

出　　处：《中国肺癌杂志》2020年第6期503-508,共6页Chinese Journal of Lung Cancer

摘　　要：背景与目的临床上肺内体积小,位置深且无实性成分的结节在电视辅助胸腔镜手术下切除给外科医生带来很多挑战。本研究的目前在于探讨经磁导航支气管镜(electromagnetic navigation bronchoscope,ENB)引导下肺部结节注入吲哚菁绿(indocyanine green,ICG)定位及在荧光腔镜下肺部小结节切除的可行性。方法2018年12月-2019年8月,我院连续16例共计30个肺周围病变患者接受了荧光胸腔镜下肺部结节切除术。术前均行磁导航引导注入ICG定位。结果所有患者均先行磁导航引导下肺结节定位术,染色完成后立即行手术切除。结节的平均大小为(11.12±3.65)mm。平均导航时间为(12.06±2.74)min,染料标记与肺部手术切除的平均间隔为(25.00±5.29)min。所有病灶均被完全切除,定位成功率100.00%,无出血及其他并发症发生,术后病理结果证实定位的准确性。结论经磁导航引导下注入荧光染剂是一种新颖且有效的方法,可以定位肺部微小不可触及的病灶。这种方法可帮助外科医生更快更方便的识别病灶,实用性强,值得推广。Background and Objective It is a great challenge for surgeons to resect pulmonary nodules with small volume,deep position and no solid components under video-assisted thoracoscopic surgery.The purpose of this study is to explore the feasibility and necessity of the localization of pulmonary nodules by injecting indocyanine green(ICG)under the guidance of magnetic navigation bronchoscope and the resection of small pulmonary nodules under the fluoroscope.Methods Between December 2018 and August 2019,sixteen consecutive patients with 30 peripheral lung lesions in our hospital received fluorescent thoracoscopic pulmonary nodule resection.Electromagnetic navigation bronchoscope(ENB)was performed before surgery to guide ICG to the target lesion.Results All patients underwent magnetic navigation-guided pulmonary nodule localization,and surgical resection was performed immediately after lo-calization was completed.The average size of the nodules was(11.12±3.65)mm.The average navigation time was(12.06±2.74)minutes,and the average interval between dye labeling and lung resection was(25.00±5.29)minutes.All lesions were completely resected,the localization success rate was 100.00%,no bleeding and other complications occurred after the localization,the postoperative pathological results confirmed the accuracy of the staining.Conclusion Indocyanine green injection under the guidance of magnetic navigation bronchoscope is an effective way to locate pulmonary nodules,which can locate small and untouchable lesions in the lung.This method can help surgeons identify lesions more quickly and accurately.It is practical and worthy of promotion.

关 键 词：肺结节 磁导航支气管镜 吲哚菁绿 荧光胸腔镜 

分 类 号：R734.2[医药卫生—肿瘤]