肺支气管血管CT三维重建辅助胸腔镜下解剖性肺段或亚段切除术前定位的应用效果观察

doi:10.3760/cma.j.cn101202-20220418-00112

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摘要目的探讨肺支气管血管CT三维重建（3D-CTBA）在单孔胸腔镜（VATS）解剖性肺段或肺亚段切除术前定位中的可靠性与临床效果。方法回顾性研究。纳入2020年1月—2022年2月在徐州市中心医院胸外科行3D-CTBA辅助单孔VATS解剖性肺段或肺亚段切除术的肺结节患者207例。其中男78例、女129例,年龄27~93（57.4±11.7）岁,肺结节最大径0.2~4.3（1.1±0.6）cm。依据术前3D-CTBA影像解剖的定位和设计进行手术。观察指标：（1）围术期及术后随访情况;（2）评价3D-CTBA无创定位肺结节的可靠性。结果（1）患者手术均顺利完成,均R0切除,无中转开胸。手术时间（131.4±59.7）min,术中出血量（92.6±76.6）mL。引流管留置时间（4.5±2.4）d。术后并发症发生率5.8%（12/207）,其中持续肺漏气（>7 d）6例、切口脂肪液化2例、乳糜胸2例、迟发性胸腔积液2例。术后30 d无二次手术。患者均获随访2~34（16.1±7.3）个月,无肿瘤复发或死亡。（2）术中解剖观察与术前3D-CTBA对比,切除的肺结节所在肺段或肺亚段的血管、支气管及其分支均与影像所示的解剖结构匹配。所有靶区肺结节完整切除且有明确的病理诊断,与影像定位相符。结论 3D-CTBA用于单孔VATS解剖性肺段或亚段切除术的手术前定位精准可靠,临床效果满意。

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	张淼
	武文斌
	王晓靖
	张辉
	李敏
	杨敦鹏
	王其斌

关键词 ：肺切除术, 解剖性肺段切除术, 胸腔镜, 解剖性肺亚段切除术, 肺支气管血管CT三维重建

Key words： Pneumonectomy Anatomical segmentectomy Thoracoscopes Subsegmental lung resection Three-dimensional computed tomography bronchography and angiography

收稿日期: 2022-04-18

通讯作者: 王晓靖,Email： wangxjdoc89@outlook.com

引用本文:

张淼, 武文斌, 王晓靖, 张辉, 李敏, 杨敦鹏, 王其斌. 肺支气管血管CT三维重建辅助胸腔镜下解剖性肺段或亚段切除术前定位的应用效果观察[J]. 中华解剖与临床杂志, 2022, 27(11): 792-796.
Zhang Miao, Wu Wenbin, Wang Xiaojing, Zhang Hui, Li Min, Yang Dunpeng, Wang Qibin. The clinical efficacy of thoracoscopic anatomical segmentectomy or subsegmentectomy assisted with preoperative localization by three-dimensional computed tomography bronchography and angiography. Chinese Journal of Anatomy and Clinics, 2022, 27(11): 792-796.

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