The Application Of CT Guided Puncture Location In Resection Of Pulmonary Nodules

Background and objective:in recent years,with the popularity of the health examination and the popularization of CT examination,the detection of pulmonary nodules is more and more.On the other hand The probability of malignancy in lung nodules varies according to tumor size,ranging from 1-80%.For lung cancer,the postoperative survival time of early lung cancer can be greatly prolonged.On the other hand,in today’s advanced information technology,people get more and more quick access to professional knowledge,many patients can not stand the psychological pressure brought by tumor observation,and strongly call for resection of pulmonary nodules.Therefore,surgical treatment of small nodules becomes necessary.the development of minimally invasive Department of thoracic surgery,Video-assisted thoracic surgry is for the majority of patients and medical staff accept,lung cancer,early postoperative survival can be prolonged,so MINI-NODULES laparoscopic surgery becomes necessary.However,it is difficult to accurately locate the small nodules with a depth of 1 cm,which is far away from the visceral pleura and the mass of the tumor itself is soft.In order to solve this problem,a few years ago that some scholars began to try to use a variety of methods for preoperative localization of small pulmonary nodules,but each has advantages and disadvantages,difficult to spread development,this paper attempts to use preoperative CT guided puncture positioning of small nodules,guided Video-assisted thoracic surgry,to explore the localization of small pulmonary nodules thoracoscope the problems in operation.In this paper,the clinical application value of CT guided puncture needle location before and after Video-assisted thoracic surgry was retrospectively analyzed from four aspects:indications,Puncture accuracy,complications and rate of transferring thoracotomyMethods We retrospectively analyzed 55 patients who underwent VATS wedge resection for pulmonary nodules between may 2014 and Apr 2016.Among them.30 patients experinced wedge resection without preopertaive Hookwire positioning technique(Group A).and 25 patients underwent preoperative pulmonary nodule positioning techniquebefore performing VATS wedge resection of the pulmonary nodule.The small nodules ranged from 0.5 cm-2 cm(mean of 9.8 mm soil to 5.3 mm).The evaluation indexes included the success rate of localization,the location related complications,the ratio of conversion to thoracotomy,rate of transferring thoracotomy and so on.We have used the success rate inpositioning technique,rate of positioning related related complications.and rate oftransferring thoracotomy to further evaluate its efficacy.Results7 patients(24%)transfered to open thoracotomy in Group A,and no patients transfered to open thoracotomy in Group B(P< 0.05).The reason for transferring to open thoracotomy for Group A is difficulties in positioning the nodluesin 25 cases,the location of min was successful in all of the 23 patients.The average time of CT localization was 14.5.There were no serious complications.Conclusion preoperative CT guided needle biopsy of small pulmonary nodules has some clinical value,which can help to locate the location of small pulmonary nodules accurately,Shorten the operation time.and the incidence of complications is low.Worthy of clinical promotion.