术前CT引导Hook-wire定位同时性多原发性肺癌的诊疗价值

Abstract
Figure/Table
References (21)
Related Citation (1)

Download: PDF (593 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To evaluate the efficacy and safety of CT-guided Hook-wire localization in the treatment of synchronous multiple primary lung cancer (SMPLC) before video-assisted thoracoscopic surgery (VATS). Methods From February 2011 to December 2016, 47 patients with SMPLC admitted to the thoracic surgery department of Jiangyin People′s Hospital Affiliated to Southeast University were retrospectively analyzed. All patients were treated with Hook-wire localization needle under CT guidance, and VATS was performed to remove the lesions. Further surgical methods were determined according to the frozen pathological results during the operation. Positioning accuracy, the success rate of VATS lung lesion resection surgery, postoperative complications and other indicators were calculated. Results Among 47 patients, there were 19 patients with unilateral SMPLC and 28 with bilateral SMPLC. All resections of lesions which guided by the inserted Hook-wire were successfully performed by VATS (success rate was 100%). The mean procedure time for the CT-guided Hook-wire localization was (34.98±5.95) min. The major complication of CT-guided Hook-wire localization was slight pneumothorax (lung compression<20%) in 7 patients(14.9%), no one needed chest tube drainage. Moderate pneumothora (lung compression ≥20%) were observed in 4 patients(8.6%). Contralateral pneumothorax occurred during operation in 2 patients (4.3%). Two patients (4.3%) had minimal hemothorax (≤50 mL) during VATS. One patient (2.1%) underwent additional wedge resection by VATS during the same procedure because no lesion was identified in the surgical specimen. Conversion thoracotomy were required in 2 patients (4.3%) for pleural adhesions. None of Hook-wires dislodged or displaced during the transport to the surgical suite. Conclusion Preoperative CT-guided Hook-wire localization is accurate, safe and has less complications. It is of great clinical value in the diagnosis and treatment of SMPLC for VATS.

Key words： Synchrony multiple primary lung cancer Hook-wire Video-assisted thoracoscopic surgery CT scan

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	YU Guiping1 SHAN Yibo1 HUANG Bin1 JIANG Gening2

Cite this article:

YU Guiping1 SHAN Yibo1 HUANG Bin1 JIANG Gening2. Diagnostic and therapeutic value of preoperative CT-guided Hook-wire localization for synchronous multiple primary lung cancer[J]. 中国医药导报, 2019, 16(11): 81-84.

URL:

http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I11/81

[1] Kozower BD，Larner JM，Detterbeck FC. Special treatment issues in non-small cell lung cancer：Diagnosis and management of lung cancer，3rd ed：American College of Chest Physicians evidence-based clinical practice guideline [J]. Chest，2013，143（5 Suppl）：e369S-e399S.
[2] 徐程，陈天羽，李霄，等.表皮生长因子受体在同时性多原发肺癌诊断中的意义[J].中华病理学杂，2017，46（5）：332-333.
[3] 韩连奎，高树庚，谭锋维，等.同时性多原发肺癌的诊治体会及处理策略新进展[J].中国肺癌杂志，2018，21（3）：180-184
[4] Liu C，Ma L，Lin F. Single-staged uniportal VATS major pulmonary resection for bilateral synchronous multiple primary lung cancers [J]. J Thorac Dis，2014，6（9）：1315-1318.
[5] 李欣，章智荣，傅毅立，等.不同组织亚型不同基因型同时性多原发肺癌（附1例病例报道）[J].中国肺癌杂志，2017，20（12）：857-860.
[6] 刘鹏，杜静波，陈鑫，等.同时多原发性肺癌的CT及病理表现[J].中国医学影像学杂志，2017，16（10）：761-763.
[7] Martini N，Melamed MR. Multiple primary lung cancers [J]. J Thorac Cardiovasc Surg，1975，70（4）：606-612.
[8] 伍勇勇，何雪明，何忠良，等.术前CT引导Hook-wire定位下胸腔镜肺小结节切除28例分析[J].浙江医学，2017， 39（23）：2147-2149.
[9] Brady JJ，Hirsch Reilly C，Guay R，et al. Combined Hookwire and Methylene Blue Localization of Pulmonary Nodules：Analysis of 74 Patients [J]. Innovations （Phila），2018，13（3）：184-189.
[10] Ambrogi MC，Melfi F，Zirafa C. Radio-guided thoracoscopic surgery （RGTS） of small pulmonary nodules [J]. Surg Endosc，2012，26（4）：914-919.
[11] Lau CT，Wong KKY. Thoracoscopic Resection of Congenital Cystic Adenomatoid Malformation in a Patient With Fused Lung Fissure Using Hookwire [J]. Innovations （Phila），2018，13（3）：226-229.
[12] 卢斌，戴玲华，赵晓东.Hook-wire肺结节定位穿刺在临床中的应用（附70例报告）[J].现代实用医学，2013，25（5）：502-503．
[13] Klinkenberg TJ，Dinjens L，Wolf RFE，et al. CT-guided percutaneous hookwire localization increases the efficacy and safety of VATS for pulmonary nodules [J]. J Surg Oncol，2017，115（7）：898-904.
[14] Iguchi T，Hiraki T，Matsui Y，et al. Short hookwire placement under imaging guidance before thoracic surgery：A review [J]. Diagn Interv Imaging，2018，99（10）：591-597. doi: 10.1016/j.diii.2018.04.001.
[15] Yu PSY，Man Chu C，Lau RWH，et al. Video-assisted thoracic surgery for tiny pulmonary nodules with real-time image guidance in the hybrid theatre：the initial experience [J]. J Thorac Dis，2018，10（5）：2933-2939.
[16] Ichinose J，Kohno T，Fujimori S. Efficacy and complications of computed tomography-guided hook wire localization [J]. Ann Thorac Surg，2013，96（4）：1203-1208.
[17] 陈若，毛文君，郑明峰，等.CT引导下Hook-wire 定位对早期肺癌术后复发率的影响[J].临床肺科杂志，2017， 22（2）：211-216.
[18] 陆艳艳，陈宏伟，鲍健，等.CT引导下Hookwire定位孤立性肺结节的应用价值及对并发症的影响观察[J].临床肺科杂志，2018，23（3）：425-428.
[19] Yoshida Y，Inoh S，Murakawa T. Preoperative localization of small peripheral pulmonary nodules by percutaneous marking under conputed tomography guidance [J]. Interact Cardiovasc Thorac Surg，2011，13（1）：25-28.
[20] Thistlethwaite PA，Gower JR，Hernandez M，et al. Needle localization of small pulmonary nodules：Lessons learned [J]. J Thorac Cardiovasc Surg，2018，155（5）：2140-2147.
[21] Iguchi T，Hiraki T，Matsui Y，et al. Preoperative short hookwire placement for small pulmonary lesions：evaluation of technical success and risk factors for initial placement failure [J]. Eur Radiol，2018，28（5）：2194-2202.