电磁导航支气管镜辅助下老年多发肺结节患者定位的临床应用

Clinical application of electromagnetic navigation bronchoscopy-guided localization in elderly patients with multiple pulmonary nodules

中文关键词: 老年  多发肺结节  吲哚菁绿  电磁导航支气管镜辅助

英文关键词: elderly  multiple pulmonary nodule  indocyanine green  electromagnetic navigation bronchoscopy

中文摘要:

      目的 分析电磁导航支气管镜辅助下联合吲哚菁绿注入法定位老年患者多发肺结节的可行性.方法 2023 年2 月—2023 年5 月,复旦大学附属华东医院7 例老年多发肺结节患者共 15 枚结节接受术前电磁导航支气管辅助下注射吲哚菁绿定位法.所有结节均为纯磨玻璃结节以及混杂磨玻璃结节.4 枚结节位于右肺上叶、3 枚结节位于右肺下叶、5枚结节位于左肺上叶、3 枚结节位于左肺下叶.结果 所有患者均在手术室全麻下完成电磁导航支气管镜并注射吲哚菁绿定位,定位结束后立刻翻身完成单孔胸腔镜肺结节切除术.其定位成功率 93.3%(14/15),无磁导航定位的相关并发症发生.患者平均年龄(65.8±4.2)岁,结节大小为(12.66±3.84)mm,结节距离脏层胸膜距离为(10.77±6.87)mm,操作平均时间为(18.67±8.74)min.术后病理显示原位腺癌6 例,微浸润腺癌6 例和侵润性腺癌3 例.结论 电磁导航辅助下注射吲哚菁绿定位术是有效且安全的方法,能帮助胸外科医师快速定位老年患者多发肺结节,节约手术时间,临床上值得推广.

英文摘要:

      Objective To analyze the feasibility of electromagnetic navigation bronchoscopy(ENB)-guided injection of indocyanine green(ICG)to locate multiple pulmonary nodules in elderly patients.Methods From February 2023 to May 2023,7 elderly patients with multiple pulmonary nodules underwent preoperative ENB-guided injection of ICG localization for 15 nodules in Huadong Hospital Affiliated to Fudan University.All nodules were pure ground glass nodules or mixed ground glass nodules.4 nodules were located in the upper lobe of the right lung,3 ones in the lower lobe of the right lung,5 ones in the upper lobe of the left lung,and 3 ones in the lower lobe of the left lung.Results All patients completed ENB-injection of ICG localization under general anesthesia in the operating room.After localization,the patient was immediately turned over to complete single-aperture thoracoscopic resection of pulmonary nodules.The success rate of localization was 93.3% (14/15),and there were no complicationsrelated to magnetic navigation localization.The mean age of patientswas(65.8±4.2)years.The size of nodules was(12.66±3.84)mm,the distance between nodules and visceral pleura was(10.77±6.87)mm,and the average operation time was(18.67±8.74)min.The postoperative pathological results demonstrated that 6 cases were ade-nocarcinoma in situ,6 ones were microinvasive adenocarcinoma and 3 ones were invasive adenocarcinoma.Conclusion ENB-guided injection of ICG localization is an effective and safe method.It can help thoracic surgeons quickly locate multiple pul-monary nodules in elderly patients,save operation time,and is worth of clinical promotion.