ObjectiveTo evaluate the safety and application value of three-dimensional reconstruction for localization of pulmonary nodules in thoracoscopic lung wedge resection.MethodsThe clinical data of 96 patients undergoing thoracoscopic lung wedge resection in our hospital from January 2019 to August 2020 were retrospectively reviewed and analyzed, including 30 males and 66 females with an average age of 57.62±12.13 years. The patients were divided into two groups, including a three-dimensional reconstruction guided group (n=45) and a CT guided Hook-wire group (n=51). The perioperative data of the two groups were compared.ResultsAll operations were performed successfully. There was no statistically significant difference between the two groups in the failure rate of localization (4.44% vs. 5.88%, P=0.633), operation time [15 (12, 19) min vs. 15 (13, 17) min, P=0.956], blood loss [16 (10, 20) mL vs. 15 (10, 19) mL, P=0.348], chest tube placement time [2 (2, 2) d vs. 2 (2, 2) d, P=0.841], resection margin width [2 (2, 2) cm vs. 2 (2, 2) cm, P=0.272] or TNM stage (P=0.158). The complications of CT guided Hook-wire group included pneumothorax in 2 patients, hemothorax in 2 patients and dislodgement in 4 patients. There was no complication related to puncture localization in the three-dimensional reconstruction guided group.ConclusionBased on three-dimensional reconstruction, the pulmonary nodule is accurately located. The complication rate is low, and it has good clinical application value.
目的 探討經右胸入路胸腔鏡下胸導管結扎在乳糜胸治療中的作用及優勢。 方法 回顧性分析南京軍區南京總醫院心胸外科 2012～2014 年采用胸腔鏡手術治療乳糜胸 18 例患者的臨床資料，男 15 例、女 3 例，年齡 56～79（66.56±6.43）歲。所有患者均采用右胸入路胸腔鏡輔助下行胸導管結扎，術中若能找到明顯破口，則在破口的兩端用 Ham-lock 夾閉胸導管，若未能找到明確的胸導管破口，則在第 8、第 9 胸椎附近用 Ham-lock 將胸導管及周圍脂肪組織一起夾閉。 結果 全組 18 例患者均完成手術，無中轉開胸，手術時間 28～45（35.83±4.58）min，術后胸腔引流時間 2～5（3.33±1.03）d，術后住院時間 5～8（6.11±1.02）d。術后無感染、吻合口瘺等嚴重并發癥，隨訪 3 個月無復發。 結論 經右胸入路胸腔鏡輔助手術結扎胸導管治療乳糜胸是一種安全、有效的治療方法，因其微創、住院時間短、手術效果確切等優點，值得在臨床上推廣。