三维重建指导下单孔荧光胸腔镜肺亚段切除肺结节的疗效分析  

Evaluation on clinical efficacy of three-dimensional reconstruction guided uniportal fluorescence thoracoscopic subsegmentectomy for the pulmonary nodules

作　　者：詹必成 刘建[1] 陈剑[1] 刘永志[1] 郭昆亮 王啸[1] 熊焱正 汤勇 古明博 Zhan Bicheng;Liu Jian;Chen Jian;Liu Yongzhi;Guo Kunliang;Wang Xiao;Xiong Yanzheng;Tang Yong;Gu Mingbo(Department of Cardiothoracic Surgery,Anqing Municipal Hospital,Anqing 246003,China)

机构地区：[1]安徽医科大学附属安庆医学中心、安庆市立医院心胸外科,安徽安庆246003

出　　处：《中华胸心血管外科杂志》2024年第11期641-646,共6页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：安徽医科大学校科研基金(2020xkj240)。

摘　　要：目的分析三维重建指导下单孔荧光胸腔镜肺亚段切除肺结节的临床效果。方法回顾性分析2021年12月至2024年2月行单孔胸腔镜肺亚段切除肺结节50例患者的临床资料,所有患者术前薄层CT扫描,并进行三维重建。12例患者术前Hookwire定位。在荧光胸腔镜下采用吲哚氰绿反染法确定段间平面。结果50例患者完成51个亚段切除。1例右上肺S1b切除未找到结节,进一步行右上肺叶切除,结节遗留在残肺,其余均顺利完成手术。术中出血(23.4±16.5)ml,手术(126.5±38.5)min,术后胸腔引流管留置(2.6±0.8)天,术后住院(4.8±1.8)天。术后肺部感染2例,其中1例合并包裹性胸腔积液,无超过3天漏气,无术后30天死亡。结论三维重建指导下单孔荧光胸腔镜肺亚段切除肺结节安全可行,但要严格掌握手术指征。Objective To analyze the clinical efficacy of three-dimensional(3D)reconstruction guided uniportal fluorescence thoracoscopic subsegmentectomy for the pulmonary nodules.Methods We retrospectively analyzed 50 patients with nodules who underwent uniportal fluorescence thoracoscopic subsegmentectomy from December 2021 to February 2024.All patients underwent thin-slice CT scanning and 3D reconstruction preoperatively.12 patients were given CT-guided hookwire localization preoperatively.The intersegmental plane was identified by fluorescence method.Results One patient was converted to right upper lobectomy due to no lesion found in S1b.The mean blood loss was(23.4±16.5)ml and the mean operative time was(126.5±38.5)min.The mean duration of postoperative drainage was(2.6±0.8)days.Mean postoperative hospitalization was(4.8±1.8)days.There were 2 cases with postoperative pulmonary infections,including one with encapsulated pleural effusion.There was no air leakage over 3 days,and no death within 30 days after surgery.Conclusion 3D reconstruction guided uniportal fluorescence thoracoscopic subsegmentectomy is a safe and feasible technique for resection of pulmonary nodules in lung subsegments,and surgical indications must be strictly controlled.

关 键 词：三维重建 荧光胸腔镜 肺亚段切除术 肺结节 

分 类 号：R655.3[医药卫生—外科学]