Clinical Research Of CT-guided Preoperatye Pulmonary Nodule Positioning Technique

Background:VATS Wedge resection is an effective method to diagnose pulmonary nodules, but it is closely associated with the location, size and histophathology of the nodule. Some pulmonary nodules are difficult to estimate their accurate position. Preoperative positioning of the nodule provides a convenient method for VAST procedures. In this article, we retrospectively analyzed the clinical significance of CT-guided preoperative pulmonary nodule positioning technique.Method:We retrospectively analyzed76patients who underwent VATS wedge resection for pulmonary nodules between Jan2010and Apr2011. Among them,36patients experinced wedge resection without preopertaive Hookwire positioning technique(Group A), and43patients underwent preoperative pulmonary nodule positioning technique before performing VATS wedge resection of the pulmonary nodule. Diameter of the lesion ranges less than2cm. Wedge resection was conducted after completing the positioning in two hours. We have used the success rate in positioning technique, rate of positioning related related complications, and rate of transferring thoracotomy to further evaluate its efficacy.Results:4patients had pneumothorax. and4patients experienced dislodge.8patients (24%) transfered to open thoracotomy in Group A. and only2patients 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 nodlues, and for Group B. severe adhesion of the tharacic cavity and dislodge contributed the most. Main contributing factor for transferring thoracotomy is the diameter of nodule.Conclusion:CT-guided preoperative pulmonary nodule positioning technique has a valuable clinical significance for small solitary pulmonary nodules, it plays an important role in accurate positioning of small pulmonary nodules, and decrease the rate of transferring thoracotomy, shorten operating time.