一体化手术室肺结节精准诊疗现状：系统性回顾研究

目的探讨一体化手术室对肺结节诊疗的安全性、可行性及有效性。 方法纳入广州医科大学附属第一医院胸外科2019年1月至2022年3月212例肺结节患者。全组病例均由同一团队麻醉医师和胸外科医师在一体化手术室完成电磁导航肺结节精确定位和单孔胸腔镜精准切除,手术均于自主呼吸麻醉下完成。收集并分析患者的肺结节定位配准时间、术程导航时间、定位成功率、切除范围、术后并发症等围手术期资料,对相关数据进行统计分析。 结果共212例患者,256个肺结节。运用电磁导航技术对肺结节进行定位,校准时间为（0.82±0.40）min,导航定位时间为（10.22±5.94）min。全组256个"靶区"肺结节,254（99.22%）个结节导航定位成功。全组患者均于电磁导航定位后行单孔胸腔镜手术,其中亚肺叶切除247例,占96.48%,肺叶切除9例,占3.52%。所有"靶区"肺结节均完整切除,切缘均为阴性。全组无出现严重并发症或死亡。术后住院时间为（1.92±0.87）d。 结论电磁导航肺结节定位,结合"无管化"自主呼吸麻醉和单孔胸腔镜切除术的优化与整合,为肺结节患者提供了一体化手术室诊疗,安全、精准、高效,值得推广。

Application the integrated operating room on localization and resection of pulmonary nodule: a systematic review

ObjectiveTo evaluate the efficacy and feasibility of the integrated room in the treating of pulmonary nodules. MethodsClinical data of patients who received treatment in the integrated operating room between January 2019 and March 2022, were collected. Registration time, localization time, precise rates, surgical extent, and surgical outcomes were analyzed. ResultsAll patients with 256 pulmonary nodules received electromagnetic navigation bronchoscopy (ENB) localization. The average registration time and localization time were (0.82±0.40) min and (10.22±5.94) min, respectively. Additionally, there are 254 (99.22%) nodules were precisely navigated. Of 212 patients who underwent ENB localization followed by minimally invasive surgery, including sublobectomy (247, 96.48%) and lobectomy (9, 3.51%) . All patients achieved negative margins. No morbidity or mortality occurred. The postoperative hospital stay was (1.92±0.87) days. ConclusionsThe study indicated that the integrated operating room, including electromagnetic navigation bronchoscopy, non-intubated anesthesia, and uniport video-assisted thoracoscopic surgery, was a feasible and effective option for patients with pulmonary nodules, which should be widely used in clinical practice.