Background: How to locate pulmonary ground-glass nodules in thoracoscopic surgery is an important clinical topic in minimally invasive thoracic surgery. There is no unified localization method at present. This study intends to investigate the accuracy and security of body surface theodolitic puncture localization method in video-assisted thoracoscopic surgery for pulmonary ground-glass nodules.
Methods: The clinical data of 41 patients from August 2018 to December 2019 were analyzed retrospectively, including 28 males and 13 females. After anesthesia, the patient was located by body surface theodolitic puncture, and then partial lobectomy was performed under video-assisted thoracoscopy. The distance from the nodule to the marked suture and the distance from the nodule to the incisal margin were measured, and the accuracy of localization, the rate of complication and the success rate of surgical resection were calculated.
Results: A total of 51 nodules in 41 patients were located by body surface theodolitic puncture localization method. The accuracy rate was 96.1%, and the average location time was 8.3 min. Puncture bleeding occurred in 5 cases (12.2%), all of which were successfully stopped by video-assisted thoracoscopy, and there were no other complications. All patients underwent thoracoscopic partial lobectomy, including 33 cases of anatomical segmentectomy and 8 cases of wedge lobectomy. All the patients in operation process smoothly. The distance between nodule and incisal margin was measured, and all specimens were more than 2 cm, reaching a safe distance. The success rate of surgical resection was 100.0%.
Conclusions: In video-assisted thoracoscopic surgery for ground glass nodules of lung, the body surface theodolitic puncture localization method can be accurate, safe and simple.
【中文题目：体表经纬穿刺定位法 在胸腔镜肺磨玻璃结节手术中的初步应用】 【中文摘要：背景与目的 肺磨玻璃结节在胸腔镜手术中如何定位是微创胸外科的重要临床课题，目前尚无统一的定位方法。本研究拟探讨体表经纬法穿刺定位法在电视胸腔镜肺磨玻璃结节手术中肺结节定位的准确性及安全性。方法 回顾性分析2018年8月-2019年12月期间我院收治的41例肺磨玻璃结节患者的临床资料，其中男性28例，女13例。患者于麻醉后采用体表经纬法穿刺法定位，然后行胸腔镜下部分肺叶切除术。对手术切除标本测量结节至标记缝线距离和结节至切缘的距离，统计定位准确率、并发症率和手术切除成功率。结果 采用体表经纬法穿刺定位法对41例患者共51枚结节进行定位，准确率达96.1%，平均定位时间8.3 min。有5例（12.2%）出现穿刺出血，均胸腔镜下成功止血，无其他并发症出现。所有患者行胸腔镜部分肺叶切除术，其中33例行解剖性肺段切除，8例行肺叶楔形切除术，手术过程均顺利。测量结节与切缘的距离，所有标本均>2 cm，达到安全距离，手术切除成功率100.0%。结论 在电视胸腔镜肺磨玻璃结节手术中，体表经纬穿刺定位法是准确、安全、简便的定位方法。】 【中文关键词：胸腔镜；磨玻璃结节；穿刺定位】.
Keywords: Ground-glass nodule; Puncture location; Thoracoscopy.