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    胸腔镜手术的定位技术:裸眼3D技术

    2019-04-13

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    作者:广东省肺癌研究所 杨学宁 & LAMP

    胸腔镜手术的定位技术:裸眼3D技术

    267. The "Glass-Free" 3D Technology in Thoracoscopic Surgery: Can Be Used to Localization Ground Grass Opacity Nodule During Operation?

    Zhexue Hao, Xukai Li, Hengrui Liang, Fei Cui, Jun Liu, *Jianxing He
    The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

    Objective: With the development and popularization of the low-dose computed tomography (LDCT) examination, more pulmonary pure ground grass opacity (GGO) nodule are found. But owing to small size and soft texture, it is difficult to locolize during operation by eyes or finger. Currently, there are many different localization methods available and each has its disadvantage, most of them are invasive operations. We introduce a "Glass-free" 3D video-assisted thoracoscopic (VATS) technology to localize and remove small pulmonary nodules in a non-invasive, fast and economical manner.
    Methods: From July 2017 to March 2018, 38 patients with lung nodules underwent the “Glass-free” 3D VATS resections for pulmonary nodules without pre-operative localization at our institution were retrospectively analyzed. Clinical parameter was recorded for each patient. The characteristics of CT were recorded for each lesion.
    Results: The mean age of patients was 56y (36-74) and the mean nodule size was 11.5 mm (4-26), distributed through both the lungs (right¼24 [upper ¼10, middle ¼2, lower ¼12] and left 14 [upper¼12, lower ¼2]). The distance from the nodule surface to the nearest pleural surface ranged from 1 to 26 mm (mean 10.6 mm) as measured on the CT images. On CT, there were 11 solid nodules (<50%consolidation/tumor [C/T] ratio100%), 11-part solid ground-glass nodules (<0%C/T ratio50%), and 16 pure ground-glass nodules (C/T ratio ¼0%). Operations were applied for each patient under glass-free 3D VATS. The final diagnoses of the 38 patients included 28 malignant (73.7%), 2 precancerous (5%), 8 benign nodules. Among the 28 primary pulmonary tumor cases,5 were adenocarcinoma in situ, 10 were minimally invasive adenocarcinoma, 12 were invasive adenocarcinoma, 1 was small cell carcinoma.
    Conclusions: "Glass-less" 3D VATS is a feasible approach for locolizing GGO for its bright field of vision and pleasant experience during operation.

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