Intraoperative longitude-latitude-depth three-dimensional localization of pulmonary nodules.

IF 4 2区医学 Q2 ONCOLOGY

Translational lung cancer research Pub Date : 2025-01-24 Epub Date: 2025-01-22 DOI:10.21037/tlcr-2024-1170

Yue Zhao, Jianhao Qiu, Anna Bright, Renchang Zhao, Rongyang Li, Zhanpeng Tang, Weiming Yue, Hui Tian, Zhenguo Sun

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引用次数: 0

Abstract

Background: Identifying small pulmonary nodules during sublobar resection via video-assisted thoracoscopic surgery (VATS) poses certain challenges. Although preoperative computed tomography (CT)-guided localization is common, it is invasive and may lead to complications. This study aims to develop a novel, non-invasive technique for improving the accuracy of pulmonary nodule localization during VATS, with the goal of reducing complications associated with traditional methods.

Methods: We developed the longitude-latitude-depth (LLD) localization method, a novel intraoperative approach for localizing small pulmonary nodules. The LLD method uses anatomical reference points derived from the lung's natural structure to guide nodule localization during surgery. This retrospective study compared patients with small pulmonary nodules (≤2 cm in diameter, consolidation tumor ratio ≤0.5, and outer one-third of the pulmonary parenchyma) undergoing either intraoperative LLD localization or preoperative CT-guided hook-and-wire localization followed by VATS at Qilu Hospital of Shandong University from March 2020 to November 2023. Propensity score matching (PSM) analysis was used to the compare clinical information and perioperative outcomes, with 176 patients in each group after matching was performed.

Results: Compared to the CT-guided localization, the LLD method achieved higher accuracy (96.59%) during surgery and had a significantly reduced localization duration (5 vs. 18 min), needle-carrying time (0 vs. 81. min), localization complications (pain: 0% vs. 4.55%; hemothorax: 0% vs. 3.41%; pneumothorax: 0% vs. 4.55%; hemoptysis: 0% vs. 6.82%), estimated blood loss (37.5 vs. 55 mL), chest tube removal time (3 vs. 4 days), postoperative pain score (3 vs. 4 score), postoperative day (5 vs. 6 days), hospitalization cost (CNY ¥39764.25 vs. CNY ¥48458.41), and failure rate (3.41% vs. 8.52%).

Conclusions: LLD localization is noninvasive, time-saving, and cost-effective and may be a feasible, safe, and effective technique for localizing small pulmonary nodules during surgery.

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术中肺结节经纬度深度三维定位。

背景：通过电视胸腔镜手术（VATS）在肺叶下切除术中识别小肺结节提出了一定的挑战。虽然术前计算机断层扫描（CT）引导定位是常见的，但它是侵入性的，可能导致并发症。本研究旨在开发一种新的、无创的技术来提高VATS中肺结节定位的准确性，以减少与传统方法相关的并发症。方法：我们发展了经纬度深度定位方法，这是一种新的术中定位小肺结节的方法。LLD方法利用肺自然结构的解剖学参考点来指导手术中结节的定位。本回顾性研究比较了2020年3月至2023年11月在山东大学齐鲁医院行术中LLD定位或术前ct引导下钩丝定位后VATS治疗的肺小结节（直径≤2cm，实变肿瘤比≤0.5，肺实质外三分之一）的患者。采用倾向评分匹配（PSM）分析比较临床资料与围手术期结局，匹配后每组176例患者。结果：与ct引导定位相比，LLD方法术中定位准确率（96.59%）更高，定位时间（5 min vs. 18 min）、载针时间（0 min vs. 81 min）显著缩短。最小)，定位并发症(疼痛：0% vs. 4.55%；血胸：0% vs. 3.41%；气胸：0% vs. 4.55%；咳血：0%对6.82%)、估计失血量（37.5对55 mL）、拔胸管时间（3对4天）、术后疼痛评分（3对4分）、术后天数（5对6天）、住院费用（39764.25元对48458.41元）、失败率（3.41%对8.52%）。结论：LLD定位无创、省时、经济，是一种可行、安全、有效的手术小结节定位技术。

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来源期刊

Translational lung cancer research Medicine-Oncology

CiteScore

7.20

自引率

2.50%

发文量

137

期刊介绍： Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.