标题：CT引导钢丝定位下单孔胸腔镜手术治疗肺孤立性结节

      作者：倪 达 1，杨志胤 1，朱余明 2，滕继平 1，程佑爽 1，朱智军 1
    (1.上海交通大学医学院附属第三人民医院胸外科，上海 201900；
2.同济大学附属上海市肺科医院胸外科，上海 200433)

      卷次： 2015年26卷9期

      【摘要】 目的 探讨CT引导钢丝定位下单孔胸腔镜手术对肺孤立性结节的诊疗价值。方法 回顾性分析
2012年2月至2014年3月上海交通大学医学院附属第三人民医院胸外科收治的SPN患者86例，CT引导下留置
带钩钢丝，沿钢丝定位处行单孔胸腔镜肺楔形切除(单孔组)，根据术中冰冻病理结果决定进一步手术方式。用同
期胸腔镜辅助小切口治疗74例SPN患者做对照(小切口组)，比较两组患者的手术时间、术中出血量、拔除胸腔引流
管时间、术后住院时间及术后并发症等。结果 单孔组在手术时间、手术出血量、拔除胸引管时间与小切口组比较
差异均有统计学意义(P<0.05)，但两组在术后并发症及住院时间等指标方面比较差异均无统计学意义(P>0.05)。
结论 采用CT引导钢丝定位下单孔胸腔镜手术治疗SPN，手术创伤小，疗效可靠，具有很好的临床推广价值。

      【关键词】 胸腔镜；肺孤立性结节；单孔；CT引导定位

      【中图分类号】 R445 【文献标识码】 A 【文章编号】 1003—6350（2015）09—1351—03


CT-guided localization single port video-assisted thoracic surgery for patients with solitary pulmonary nodule.
NI Da 1, YANG Zhi-yin 1, ZHU Yu-ming 2, TENG Ji-ping 1, CHENG You-shuang 1, ZHU Zhi-jun 1.
1. Department of
Thoracic Surgery, Shanghai Third People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai
201900, CHINA; 2. Department of Thoracic Surgery, Shanghai Pulmonary Disease Hospital Affiliated to Tongji University,
Shanghai 200433, CHINA

【Abstract】 Objective To evaluate clinical outcomes of CT-guided localization single port video-assisted tho-
racic surgery (VATS) for patients with solitary pulmonary nodule (SPN). Methods Eighty-six patients with SPN who
underwent CT-guided localization single port VATS from February 2012 to March 2014 in Shanghai Third People's Hospi-
tal, Shanghai Jiao Tong University School of Medicine were enrolled as the single port group. Hookwire localization pins
were retained guided by CT scan into the patients' body, and single port VATS pulmonary wedge resection was adopted. Ac-
cording to the results of intraoperative frozen pathology, further treatment method was decided. Another 74 patients with
SPN who underwent video-assisted mini-thoracotomy (VAMT) in the same period were selected as mini-thoracotomy
group. The clinical outcomes, including operation time, intraoperative blood loss, chest drainage duration, postoperative
hospitalization time and postoperative complications, were compared between the two groups. Results There were statis-
tical differences in the operation time, intraoperative blood loss, and chest drainage duration between the two groups (P<
0.05). There were no statistical differences in postoperative hospitalization time and postoperative complications between
the two groups (P>0.05). Conclusion CT-guided localization single port VATS has less injury, reliable curative effect in
treatment of SPN, which possesses great value in clinical promotion.