达芬奇机器人周围肺磨玻璃结节术前定位指征的研究

目的探讨肺磨玻璃结节的术前定位指征。方法纳入北部战区总医院自2012年4月至2019年9月收治的192例应用达芬奇机器人手术系统切除肺部磨玻璃结节患者,男95例、女97例,平均年龄(56.47±11.79)岁。所有患者完善术前检查,按术前是否予以定位,分为定位组(n=97)和不定位组(n=95);定位组按磨玻璃实质不同分为纯磨玻璃结节(pGGO)组(n=23),混合磨玻璃结节(mGGO)组(n=74);未定位组分为pGGO组(n=14),mGGO组(n=81)。各个组又根据结节大小及与胸膜距离与能否探查及结节,得出相应的线性函数。结果术前行亚甲蓝定位组的手术时间短于不定位组手术时间。在散点图中描绘结节相对应直径和深度及能否探及到的坐标点,并对所有坐标点进行线性回归得出的线性函数深度=0.648×直径–1.446(单位为mm)]可作为达芬奇机器人手术pGGO节术前定位的指征;线性函数深度=0.5595×直径ᒰ0.56(单位为mm)]可作为达芬奇机器人手术mGGO术前定位的指征。结论结果提示该方程可作为临床周围肺磨玻璃结节的术前定位指征。

Preoperative localization indication of clinical peripheral pulmonary ground-glass nodules by Da Vinci robot surgery

Objective To investigate the preoperative localization of pulmonary glabrous nodules.Methods A total of 192 patients admitted to General Hospital of Northern Theater Command from April 2012 to September 2019 were selected for the study.There were 95 males and 97 females at an age of 56.47±11.79 years.All patients completed preoperative examination,and were divided into a positioning group(n=97)and a non-positioning group(n=95)according to whether the preoperative positioning was performed.And the surgical indicators between the two groups were compared.According to the substance of ground-glass opacity,they were divided into a pure ground-glass nodules group(n=23)and a mixed ground-glass nodules group(n=74)in the positioning group and a pure ground-glass nodules group(n=14)and a mixed ground-glass nodules group(n=81)in the non-positioning group.According to the size and distance of the nodules from the pleura and whether the nodules could be detected,the corresponding linear function was obtained.Results The operative time of methylene blue localization group was shorter than that of the no localization group.In the scatter plot,the corresponding diameter and depth of the nodules and the corresponding coordinate points which can be explored were described.And linear regression was performed on all the coordinate points to obtain the linear function:depth=0.648×diameter–1.446(mm).It can be used as an indication for the preoperative localization of pure ground-glass nodules in Da Vinci robotic surgery.Linear function:depth=0.5595×diameterS0.56(mm).It can be used as an indication of preoperative localization of mixed ground-glass nodules in Da Vinci robotic surgery.Conclusion This equation can be used as a preoperative indication for clinical peripheral pulmonary ground-glass nodules.