“肺表面段间比例标志”用于肺段切除术段间平面识别的初步验证研究  

A preliminary validation of the "lung surface intersegmental constant proportion landmarks" in identifying intersegmental planes during segmentectomy

作　　者：朱云柯[1] 周健[1] 蒲强[1] 梅建东[1] 马林[1] 林锋[1] 刘成武[1] 徐昱扬 杨懿[2] 任福强 刘伦旭[1] ZHU Yunke;ZHOU Jian;PU Qiang;MEI Jiandong;MALin;LIN Feng;LIU Chengwu;XU Yuyang;YANG Yi;REN Fuqiang;LIU Lunxu(Department of Thoracic Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Department of Thoracic Surgery,The Third People's Hospital of Chengdu,Chengdu,610014,P.R.China)

机构地区：[1]四川大学华西医院胸外科,成都610041 [2]成都市第三人民医院胸外科,成都610014

出　　处：《中国胸心血管外科临床杂志》2021年第12期1476-1481,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川大学华西医院1·3·5学科卓越发展基金(ZYGD18021,ZYJC18009)。

摘　　要：目的验证本中心前期开发的"肺表面段间比例标志"在肺段切除术中用于段间平面识别的可行性和准确性。方法前瞻性纳入2021年9~10月于四川大学华西医院胸外科及成都市第三人民医院胸外科行胸腔镜肺段切除术患者,以目前相对客观可行的静脉注射吲哚菁绿确定段间平面的方法作为对照标准,在手术中比较"肺表面段间比例标志"与静脉注射吲哚菁绿确定段间平面的一致性。在术中首先依据"肺段表面比例标志"制成的"可视化肺段表面标志模方"确定肺表面主要段间标志点,然后通过外周静脉注射12.5 mg吲哚菁绿显示荧光显色平面。当用肺段表面标志确定的肺段标志点与吲哚菁绿荧光染色显示的段间界限之间的距离≤1cm时,判定为肺段表面标志确定的标志点与荧光显色段间平面一致。只要有一个标志点结果判定为一致,则认为采用该方法识别段间平面是可行和准确的。结果共纳入21例行胸腔镜肺段切除术患者。其中男5例、女16例,中位年龄55(34~76)岁。左侧手术11例;右侧手术10例。在21例肺段切除术中,应用肺段表面标志确定的段间标志点均至少有一个与吲哚菁绿荧光染色确定的段间平面是一致的。结论 "肺表面段间比例标志"方法与吲哚菁绿荧光染色法对段间平面的识别一致,是一种可行的准确识别段间平面的方法。Objective To verify the feasibility and accuracy of the "lung surface intersegmental constant proportion landmarks", developed by our center, in identifying intersegmental planes during pulmonary segmentectomy.Methods We prospectively enrolled the patients who planned to receive thoracoscopic segmentectomy in West China Hospital of Sichuan University and The Third People’s Hospital of Chengdu from September 2021 to October 2021. We took a relatively objective and feasible method, intravenous injection of indocyanine green, in identifying intersegmental planes as standard control. We intraoperatively judged the consistency between "lung surface intersegmental constant proportion landmarks" and intravenous injection of indocyanine green in identifying intersegmental planes. We discerned main landmarks of intersegmental plane by the constant proportion segment module, which was built based on the "lung surface intersegmental constant proportion landmarks", as well as distinguished the planes with discrepant fluorescence by peripheral intravenous indocyanine green injection. When the distance between the landmarks determined by the "ung surface intersegmental constant proportion landmarks" and the segmental boundaries displayed by indocyanine green fluorescence staining was ≤1 cm, the landmarks were judged to be consistent with the planes with discrepant fluorescence.As long as one of the landmarks was judged to be consistent, the method was considered to be feasible and accurate.Results A total of 21 patients who underwent thoracoscopic segmentectomy were enrolled, with 5 male and 16 female patients. The median age was 55 years, ranging from 34 to 76 years. A total of 11 patients received left-side surgery, while10 patients received right-side surgery. In the operations of 21 pulmonary segmentectomies, at least one intersegmental landmark determined by the "lung surface intersegmental constant proportion landmarks" was consistent with the intersegmental plane determined by indocyanine green fluorescence staining

关 键 词：段间平面 肺表面段间比例标志 肺段表面标志 可视化 肺段表面标志模方 肺段切除术 手术 

分 类 号：R734.2[医药卫生—肿瘤]