电视胸腔镜手术前CT引导下亚甲蓝和/或Hookwire定位肺磨玻璃结节

目的 探讨肺磨玻璃结节（GGN）电视胸腔镜手术（VATS）前CT引导下亚甲蓝染色和/或Hookwire定位结节的临床价值。方法 对141例肺GGN患者（160枚结节）均在CT引导下亚甲蓝染色和/或Hookwire定位结节后行VATS，计算定位成功率、穿刺并发症发生率及手术成功率。结果 141例均成功定位并切除肺GGN。单独亚甲蓝染色定位18枚，Hookwire定位12枚，二者联合定位130枚，定位成功率均为100%。穿刺过程中少量肺出血25例，气胸38例，肺出血并发气胸13例。术后病理示恶性结节117枚，良性结节43枚。结论 对肺GGN行VATS术前CT引导下亚甲蓝染色和/或Hookwire均可准确定位结节，有助于减少穿刺并发症、提高切除成功率。

CT-guided methylene blue and/or Hookwire localization ofpulmonary ground-glass nodules before video-assisted thoracoscopic surgery

Objective To explore the clinical application value of CT-guided methylene blue staining and/or Hookwire localization of pulmonary ground-glass nodule (GGN) before video-assisted thoracoscopic surgery (VATS). Methods Totally 141 patients with 160 GGN underwent VATS after CT-guided methylene blue staining and/or Hookwire implantation for localization of nodules. The success rate of localization, puncture complications and success rate of surgery were calculated. Results All GGN were successfully located and resected. Among 160 nodules, 18 were located with stained with methylene blue, 12 with Hookwire implantation, while 130 nodules were located with combination of two methods, and the success rates of methylene blue staining, Hookwire implantation and combination of these two methods were all 100%. Small amount of pulmonary hemorrhage and pneumothorax were observed in 25 and 38 cases respectively during puncture, including 13 cases with both pulmonary hemorrhage and pneumothorax. Postoperative pathology showed that 117 nodules were malignant and 43 were benign nodules. Conclusion CT-guided methylene blue staining and/or Hookwire implantation before VATS can accurately locate GGN, reduce puncture complications and improve the success rate of resection.