Application Of Hook-Wire Localization Technique In Surgical Treatment Of Peripulmonary Small Nodules

ObjectiveTo evaluate the efficacy and safety of Hook-wire localization technique in the surgical treatment of peripulmonary small nodules,and to analyze and study its learning curve,so as to provide reference for the surgical treatment of peripulmonary small nodules.MethodsThe clinical data of 115 patients with peripulmonary small no dules from June 2016 to December 2019 were analyzed retrospecti vely.The baseline information of the patients was recorded,such a s sex,age,smoking history,pulmonary function,basic pulmonary diseases and the location,diameter,density and depth of the nodul es.According to whether they received Hook-wire localization or n ot,they were divided into two groups:localization group(n=55)and control group(n=60).The operation conditions of the two groups were recorded,such as the localization time,depth,complic ations,interoperative time,and operation time,operation mode,con version rate and its causes,pathological results,time of postoperati ve drainage tube and hospitalization expenses.Statistical analysis s oftware SPSS22.0 was used to analyze the original data,compare t he statistical differences between the two groups of data,and use the cumulative summation analysis method to draw the Hook-wire 1 ocalization learning curve.Results1.There were 115 patients in the localization group and the control group,with an average age of 57.78 years.Women accounted for about 64.35%(74/115)in all nodules,which mainly occurred in the upper lobe of the right lung(43/115).The nodule diameter was smaller,the density was lower,and the position was deeper in the localization group.The difference was statistically significant(p<0.05).2.In the localization group,the success rate of localization was 96%(53/55),the average puncture depth was 35.08±11.57 mm,the localization time was 13.78±4.09 min,and the interoperative time was 94.46±36.62 min.The localization process was smooth,and the incidence of common complications such as pneumothorax and local hematoma was 30.9%Basic pulmonary diseases,smoking history and puncture depth>40mm were the risk factors for pneumothorax and local hematoma.One patient had transient coma during localization and one patient had hook-wire delocalization during video-assisted thoracoscopic surgery.3.With the increase of the number of puncture cases,the puncture location time gradually shortened and reached a stable level,and the incidence of complications decreased slowly.The cumulative sum value ?was used to draw the learning curve and the polynomial curve fitting showed that in the 18th operation,the learning curve was successfully crossed and the operator reached a preliminary level of proficiency.4.The success rate of thoracoscopic wedge pneumonectomy in the localization group was 92.16%,which was significantly higher than that in the control group(78.18%).However,in terms of operation time,the average operation time of general anesthesia in the localization group was 115.27±42.63 40.90min,which was significantly higher than that in the control group(97.46±40.90min).There was no significant difference in operation time,operative complications,postoperative days with tube and hospitalization cost between the two groupsConclusionHook-wire localization technique has the advantages of low difficulty,high accuracy,safety and reliability.it can significantly improve the success rate of thoracoscopic wedge pneumonectomy in patients with peripheral pulmonary nodules,and plays an important role in the surgical treatment of peripheral pulmonary nodules.