Puncture positioning versus free-of-puncture positioning under three-dimensional navigation in the anatomical segmentectomy for pulmonary nodules: A retrospective cohort study
10.7507/1007-4848.202007085
- VernacularTitle:三维导航免穿刺和穿刺定位行解剖性肺段切除术治疗肺结节的回顾性队列研究
- Author:
Shuo HU
1
;
Qi WANG
1
;
Haixing WEI
1
;
Xianglong PAN
1
;
Zhicheng HE
1
;
Jing XU
1
;
Yining ZHU
1
;
Weibing WU
1
;
Liang CHEN
1
Author Information
1. Department of Thoracic Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, P.R.China
- Publication Type:Journal Article
- Keywords:
Ground-glass nodule;
three-dimensional reconstruction;
preoperative positioning;
pulmonary segmentectomy
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(10):1202-1206
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility and clinical value of free-of-puncture positioning in three-dimension-guided anatomical segmentectomy for ground-glass nodule (GGN) compared with percutaneous positioning. Methods Clinical data of 268 enrolled patients undergoing anatomical pulmonary segmentectomy from October 2018 to June 2019 were retrospectively collected, including 75 males and 193 females with an average age of 56.55±12.10 years. The patients were divided into two groups, including a percutaneous positioning group (n=89) and a free-of-puncture positioning group (n=179). Perioperative data of the two groups were compared. Results The average CT scan times of the percutaneous positioning group was 3.01±0.98 times, and the numerical rating scale (NRS) score of puncture pain was 3.98±1.61 points. Pulmonary compression pneumothorax (≥30%) occurred in 7 (7.87%) patients and intercostal vascular hemorrhage occurred in 8 (8.99%) patients after puncture. Lung nodules were successfully found and removed in both groups. There was no statistically significant difference between the two groups in the location of nodules (P=0.466), operation time (151.83±39.23 min vs. 154.35±33.19 min, P=0.585), margin width (2.07±0.35 cm vs. 1.98±0.28 cm, P=0.750), or the number of excised subsegments (2.83±1.13 vs. 2.73±1.16, P=0.530). Conclusion Anatomical segmentectomy with three-dimensional navigation avoids the adverse consequences of puncture, which has the same clinical efficacy and meets the requirements of oncology compared with percutaneous positioning. The free-of-puncture positioning method can be used for GGN located in the central region of pulmonary segment/subsegment or adjacent to intersegment veins instead of percutaneous positioning.
