关键词: 肺小结节, 体表定位, 胸腔镜

Abstract: Background and purpose: At present, the published articles have indicated that pulmonary nodule surgery positioning is mainly focused on the CT-guided preoperative localization. This study aimed to explore a simpler, safe and reliable method of lung nodule localization, in order to provide precise positioning of pulmonary nodules for thoracoscopic lung resection. Methods: Fifty-six patients with small pulmonary nodules received CT scanning to find the position of the small nodules on the chest wall before partial lung resection. Venous catheter was used in the preoperative location points. We exhorted the anesthesiologist to do the lung inflation. The positioning point of the lung surface was left using the electric coagulation for the metal inner core of casing needle. The location of the nodule was confirmed by the electric coagulation and burning point. We counted location accuracy rate, complication rate, video-assisted thoracic surgery (VATS) success rate of pulmonary resection. Results: The data of the distance between pulmonary nodules anchor point and nodules of the surface location method on the chest wall were collected. Finally, the operation success rate was 94.6%. The small nodules in 3 cases were found to have a significant deviation (>1.5 cm) from the positioning points. There were 2 cases with active bleeding (3.6%), no other complications occurred. Conclusion: In contrast to other preoperative localization methods (such as hookwire), intraoperative localization of lung nodules on the body surface during operation can protect patients from prolonged exposure to radiation, reduce pain and psychological burden of patients, reduce the steps of preoperative localization. Intraoperative immediate operation could avoid other complications of invasive location method. It is a simple, safe, economical and accurate method for the preoperative localization of pulmonary nodules.

Key words: Small pulmonary nodules, Body surface localization, Thoracoscopy