虚拟手术规划在肺结节微弹簧圈定位胸腔镜切除术中的应用  

APPLICATION OF VIRTUAL SURGICAL PLANNING IN THORACOSCOPIC RESECTION WITH MICROCOIL LOCALIZATION FOR PULMONARY NODULES

作　　者：崔翔宇[1] 鲁瑞珍 由玉梅[1] 韩文洁 张志学[1] 赵景岚 CUI Xiangyu;LU Ruizhen;YOU Yumei;HAN Wenjie;ZHANG Zhixue;ZHAO Jinglan(Department of Thoracic Surgery,The Affiliated Central Hospital of Qingdao University,Qingdao 266042,China)

机构地区：[1]青岛大学附属青岛市中心医院胸外科,山东青岛266042 [2]青岛大学附属妇女儿童医院体检中心

出　　处：《青岛大学学报（医学版）》2023年第6期921-925,共5页Journal of Qingdao University(Medical Sciences)

基　　金：青岛市医药科研指导计划项目(2020-WJZD072)。

摘　　要：目的探讨基于医学影像控制系统虚拟围手术期规划在肺结节有创定位解剖性亚肺叶胸腔镜切除术中的应用价值。方法收集2019年4月—2020年7月于青岛市中心医院胸外科行胸腔镜亚肺叶切除术的病人75例。根据对病人肺结节采取的定位方法分为三维重建、微弹簧圈及三维重建+微弹簧圈3组,比较3组并发症、定位时间、手术时间、确定结节位置时间、使用闭合器钉仓数量、结节一次性切除情况及住院总费用的差异。结果3组定位方法定位时间的差异有统计学意义(F=265.37,P<0.05),三维重建+微弹簧圈组较三维重建组和微弹簧圈组的定位时间长,三维重建组较微弹簧圈组的定位时间长(P<0.05)。3组确定病变结节位置时间差异有统计学意义(F=2.98,P<0.05),三维重建+微弹簧圈组长于三维重建组和微弹簧圈组(P<0.05)。3组使用闭合器钉仓数量差异有统计学意义(F=2.51,P<0.05),三维重建+微弹簧圈组使用数量少于三维重建组(P<0.05)。3组的手术时间、住院总费用和结节一次切除率差异无显著意义(P>0.05)。结论肺结节穿刺定位后行三维重建虚拟手术规划并联合微弹簧圈标记定位,在解剖性亚肺叶胸腔镜切除术中可确保安全切缘距离,同时能迅速确定离体组织病变结节位置,有精准、安全、有效的特点,具有很好的临床应用价值。Objective To evaluate the value of perioperative virtual planning based on the medical image control system for thoracoscopic anatomical sublobectomy with invasive localization for pulmonary nodules.Methods We included a total of 75 patients who underwent thoracoscopic sublobectomy in the Department of Thoracic Surgery of Qingdao Central Hospital from April 2019 to July 2020.According to the lung nodule localization methods,they were divided into three groups:three-dimensional(3D)reconstruction group,microcoil group,and 3D reconstruction+microcoil group.The three groups were compared in terms of complications,localization time,surgical time,nodule localization time,the number of closure staples used,first-attempt success rate for nodule resection,and total hospitalization cost.Results The localization time differed significantly between the three groups(F=265.37,P<0.05);the 3D reconstruction+microcoil group had a significantly longer localization time than the 3D reconstruction group and the microcoil group,and the 3D reconstruction group had a significantly longer localization time than the microcoil group(P<0.05).The nodule localization time was significantly different between the three groups(F=2.98,P<0.05),which was significantly longer in the 3D reconstruction+microcoil group than in the 3D reconstruction group and the micro coil group(P<0.05).There was a significant difference in the number of staples used between the three groups(F=2.51,P<0.05);the 3D reconstruction+microcoil group used significantly fewer staples than the 3D reconstruction group(P<0.05).No significant differences were found between the three groups in surgical time,total hospitalization cost,and first-attempt success rate for nodule resection(P>0.05).Conclusion 3D reconstruction-based virtual surgical planning combined with microcoil localization after puncture localization of pulmonary nodules can ensure a safe distance to the margin and quickly determine the location of no-dules during thoracoscopic anatomical sublobectomy.It is accurat

关 键 词：成像 三维 胸外科手术 电视辅助 定位 多发性肺结节 

分 类 号：R445[医药卫生—影像医学与核医学] R561[医药卫生—诊断学]