首页|CT引导下吲哚菁绿注射定位肺小结节在胸外科手术中的应用

CT引导下吲哚菁绿注射定位肺小结节在胸外科手术中的应用

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目的 探讨CT引导下吲哚菁绿(indocyanine green,ICG)注射定位肺小结节在胸腔镜手术中的可行性及安全性。方法 2021 年9 月~2023 年6 月,我们对96 例共124 枚肺小结节定位后行胸腔镜下肺结节切除术。术前 1d内先行CT引导下确认穿刺针尖距离结节位置小于10 mm,注射0。04 ml ICG溶液进行肺结节定位,继而在胸腔镜下行肺结节切除术。结果 96 例共成功定位124 枚结节,结节大小5~10 mm,平均8 mm。定位时间9~20 min,平均11 min。荧光显影持续时间超过22 h。术后病理:原位腺癌45 枚;腺癌62 枚,其中53 枚微浸润性腺癌,9 枚浸润性腺癌;不典型增生 17 枚。8 例轻度气胸,3 例痰中带血,均无需特殊处理。结论 CT引导下ICG注射定位肺内小结节准确度高且安全有效。
CT Guided Indocyanine Green Injection for Localization of Small Pulmonary Nodules in Thoracic Surgery
Objective To explore the feasibility and safety of CT guided indocyanine green(ICG)injection for localization of small pulmonary nodules in thoracoscopy surgery.Methods Thoracoscopic resection of pulmonary nodules was performed in 96 cases with a total of 124 pulmonary nodules from September 2021 to June 2023.Within 1 day before surgery,under the CT guidance,we firstly confirmed that the needle tip was less than 10 mm from the nodule,and then 0.04 ml of ICG solution was injected for pulmonary nodule localization,followed by thoracoscopic resection of pulmonary nodules.Results A total of 124 nodules were successfully located in the 96 patients.The average nodule size was 8 mm(range,5-10 mm),and the average positioning time was 11 min(range,9-20 min).The duration of fluorescence development lasted for over 22 h.Postoperative pathology showed 45 lesions of adenocarcinomas in situ,17 lesions of atypical hyperplasia,and 62 lesions of adenocarcinomas(including 53 microinvasive adenocarcinomas and 9 invasive adenocarcinomas).Among them,8 patients had mild pneumothorax and 3 patients had blood in sputum,all of which did not require special treatment.Conclusion CT guided ICG injection has high accuracy,safety,and effectiveness for localization of small pulmonary nodules.

Indocyanine greenPulmonary nodulesPreoperative positioningThoracoscopy

杨刚、付金松、严亚鹏、汪佳玮、卞英南、张健

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铜陵市立医院胸外科,铜陵 244000

吲哚菁绿 肺结节 术前定位 胸腔镜

2024

中国微创外科杂志
北京大学

中国微创外科杂志

CSTPCD北大核心
影响因子:2.21
ISSN:1009-6604
年,卷(期):2024.24(5)
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