Localizating and Extracting Small Peripheral Nodules of Lung with Simulating Radiaotherapy Combining Methylene Blue Staining
10.3779/j.issn.1009-3419.2016.09.03
- VernacularTitle:模拟放疗引导穿刺染色定位切除外周肺部微小结节
- Author:
MAO FENG
1
;
ZHANG LIANG
;
GU HENGLE
;
ZHANG HUI
;
LV CHANGXING
;
SHEN-TU YANG
Author Information
1. 上海交通大学附属胸科医院/上海市肺部肿瘤临床医学中心胸外科
- Keywords:
Small pulmonary nodule;
Radiotherapy planning system;
Puncture under CT location;
Methylene injection;
Wedge resection
- From:
Chinese Journal of Lung Cancer
2016;19(9):577-583
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective With the extensively application of HRCT (high resolution CT) and the popularization of early lung cancer screening, the proportion of small nodullar lung cancer to be operated increases rapidly. Identifying the focus lesions quickly and accurately in operation has shown to be a challenge. We carried out this research try-ing to make use of and evaluate a new method that localizaes and extracts small peripheral pulmonary nodules by way of simu-lating radiaotherapy combining methylene blue staining.Methods From February 2012 to January 2015, 97 patients with 100 peripheral pulmonary nodules ≤10 mm in size were simulated puncturing using a radiotherapy planning. When the anaesthesia came into use, methylene blue dye was injected to the virtually identiifed point corresponding to the surface point, according to the angle and depth previously computed by the radiotherapy planning. hTe video-assisted thoracoscopic surgery (VATS) wedge resections of the marked lesions were undertaken and the specimens were sent for frozen pathologic examination. hTe interval time from anesthesia-completing to puncture and injection, hTe interval time from methylene blue injection to iden-tifying the stained area and the distances between the centre point of the stains and edge of coloured lesion were recorded. Results Our preoperative localization procedure was successful in 96 of 100 (96%) nodules. hTe interval time from anesthesia-completing to puncture and injection of methylene blue were (4.85±1.25) min. hTe interval time from methylene blue injec-tion to identifying the stained area was (16.36±2.36) min. hTe distances between the centre point of the stains and edge of coloured lesion were (4.78±2.51) mm. No complication was observed in all participants.Conclusion hTe new method of locating peripheral pulmonary nodules by simulating simulating radiaotherapy combining methylene blue staining has a high success rate and no complication for localizing small peripheral pulmonary lesions, avoiding the fear and pain of the patients untaken puncture without anaesthesia reducing radial damage.
