[Application of CT-guided Localization with Medical Glue for Single and Two or More Small Pulmonary Nodules before Video-assisted Thoracic Surgery]

Zhongguo Fei Ai Za Zhi. 2022 Jan 20;25(1):1-6. doi: 10.3779/j.issn.1009-3419.2021.102.52.
[Article in Chinese]

Abstract

Background: The localization of pulmonary nodules is related to whether the lesions can be found and removed accurately and quickly. It is an important link for the success of minimally invasive video-assisted thoracic surgery (VATS). This study investigated the feasibility of medical glue localization under VATS video-assisted thoracoscopic computed tomography (CT) guidance for single pulmonary nodule and more than two pulmonary nodules, and compared with the accuracy and safety of single nodule localization.

Methods: A retrospective analysis of the clinical data of patients who underwent unilateral CT-guided medical glue localization before VATS from November 2018 to March 2021 were performed, the patients was divided into multiple pulmonary nodules group (localized nodules ≥2) and single pulmonary nodule group according to the number of localized nodules. The localization time, success rate and complication rate of the two groups were compared.

Results: There were 126 nodules in the two groups, including 62 in single pulmonary nodule group and 64 in multiple pulmonary nodules group. The average single nodule localization time was (13.23±4.5) min in single pulmonary nodule group and (10.52±2.8) min in multiple pulmonary nodules group, the difference between the two groups is statistically significant (P<0.05). The localization success rate of single pulmonary nodule group and multiple pulmonary nodules group were 100% and 98.4% separately, the difference between the two groups was not statistically significant (P>0.05). All VATS were successfully completed after localization. The incidence of pneumothorax was higher in multiple pulmonary nodules group than in single pulmonary nodule group (P=0.07).

Conclusions: Compared with localization of single lung nodule, unilateral CT-guided medical glue localization for multiple pulmonary nodules before VATS is also feasible and accuracy, it is worthy of clinical application. But the higher rate of pneumothorax should be paid attention to.

【中文题目:CT引导下医用胶在胸腔镜术前单侧多个或 单一肺结节定位的应用】 【中文摘要:背景与目的 肺结节定位关系到能否精准、快捷找到并切除病灶,是微创胸腔镜手术(video-assisted thoracic surgery, VATS)成功的重要环节。本研究探讨单一肺结节与两枚以上肺结节VATS术前计算机断层扫描(computed tomography, CT)引导下医用胶定位的可行性,并与单个结节定位的准确性、安全性进行比较。方法 回顾2018年11月-2021年3月我院VATS术前行CT引导下医用胶定位单侧肺部结节患者的临床资料,按定位结节的数量分为单一结节定位组与多个结节定位组(定位结节数≥2个)。对比两组患者定位时间、成功率、并发症发生率等。结果 两组共126例结节,其中单一结节定位组62例,多个结节定位组64例。平均单个结节定位时间单一结节定位组为(13.23±4.5)min,多个结节定位组为(10.52±2.8)min,两组间差异有统计学意义(P<0.05)。单一结节定位组定位成功率为100%,多个结节定位组为98.4%,两组无统计学差异(P>0.05)。定位后所有胸腔镜手术均顺利完成。多个结节定位组气胸的发生率明显高于单一结节定位组(P=0.07)。结论 与单侧肺结节定位相比,单侧CT引导下胸腔镜下医用胶定位多发性肺结节也是可行和准确的,值得临床应用。但应注意气胸发生率较高。 】 【中文关键词:多发肺结节;医用胶定位;胸腔镜手术】.

Keywords: Medical glue localization; Multiple pulmonary nodules; Thoracoscopy surgery.

MeSH terms

  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / surgery
  • Multiple Pulmonary Nodules / diagnostic imaging
  • Multiple Pulmonary Nodules / surgery
  • Pneumothorax
  • Retrospective Studies
  • Solitary Pulmonary Nodule* / diagnostic imaging
  • Solitary Pulmonary Nodule* / surgery
  • Thoracic Surgery, Video-Assisted
  • Tomography, X-Ray Computed

Grants and funding

本研究受首都医科大学临床专科学院(系)开放课题(No.RG00667)资助