[A Preliminary Study to Evaluate the Efficacy and Safety of A Optimized Computed Tomography-guided Pulmonary Nodule Microcoil Localization Technique].

: 【中文题目：预充式CT引导下肺内小结节微弹簧圈穿刺
定位法的初步探讨】 【中文摘要：背景与目的 肺内小结节微弹簧圈穿刺定位是微创手术切除肺内小结节常用的术前定位方法，然而该方法仍有操作复杂、轻微并发症多等不足之处，我们将原有方法进行了优化。本研究旨在探讨优化后的预充式计算机断层扫描（computed tomography, CT）引导下肺内小结节微弹簧圈穿刺定位法在临床中的应用价值。方法 对2018年9月-2019年1月间31例患者的35枚肺结节，于术前采用预充式CT引导下肺内小结节微弹簧圈穿刺定位，然后施行胸腔镜下（video-assisted thoracoscopic surgery, VATS）手术。统计分析定位操作相关数据、成功率、并发症、病理结果等。结果 定位成功率97.1%，VATS切除成功率100%。CT定位时间平均10.1 min（5 min-31 min），微创切除病灶所需时间平均38.2 min（10 min-100 min）。术中发现微弹簧圈脱位回缩至胸壁内1例，通过充气膨肺状态下自胸壁穿刺点刺入穿刺针，成功定位肺内结节并予以切除。3例患者定位后发生微量气胸，但无需闭式引流处理。3例患者出现肺内血肿。35枚肺结节术后病理结果为：高分化腺癌15例，原位癌7例，微浸润腺癌5例，非典型腺瘤样增生4例，肺内淋巴结增生、炎性结节各2例。结论 采用预充式微弹簧圈定位肺内小结节简便、安全、有效，值得推广。】 【中文关键词：断层扫描；定位；肺肿瘤】. METHODS: 35 pulmonary nodules from 31 patients between September 2018 and January 2019 were localized by the optimized method before VATS. The success rate, complications, pathological results and localization operations related data were statistically analyzed. RESULTS: The success rate of localization was 97.1%, and the success rate of VATS removal was 100%. The average operation time was 10.1 min (5 min-31 min), and the average time required for resection of lesions was 38.2 min (10 min-100 min). During the surgery, the microcoil of one patient was found to be dislocated and retracted into the chest wall. A puncture needle was inserted intolung tissue from the chest wall puncture point after the lung was inflated, and then the pulmonary nodule were successfully located and removed. A minor pneumothorax occurred in 3 patients, but no closed drainage was needed. Three patients developed intrapulmonary hematoma. The pathological results of 35 pulmonary nodules included 15 well-differentiated adenocarcinoma, 7 carcinoma in situ, 5 microinvasive adenocarcinoma, 4 atypical adenomatoid hyperplasia, 2 intrapulmonary lymph node hyperplasia, 2 inflammatory nodules. CONCLUSIONS: For small pulmonary nodules requiring thoracoscopic surgery, the optimized computed tomography-guided pulmonary nodule microcoil localization technique is convenient, safe and effective, and worthy of promotion to use.