Application Analysis Of Preoperative CT-guided Hookwire Localization Of Pulmonary Nodules In Thoracoscopic Segmentectomy

Objective :With the thorough implementation of the concept of precision surgery in general thoracic surgery,it has gradually developed into a minimally invasive precision thoracic surgery mode.At the same time,sublobar resection,which can retain more lung function,gradually enters people’s field of vision and is widely recognized by thoracic surgeons.However,due to the small size,low density and deep location of the lesions,intraoperative exploration is difficult,so accurate positioning before surgery is still a problem that needs to be solved urgently.This article discusses the clinical value of preoperative CT-guided Hookwire local ization of solitary pulmonary nodules in thoracoscopic segmentectomy.Methods :From January 2018 to May 2019,43 patients with pulmonary nodules were treated in our hospital,with a total of 47 lesions.All patients underwent total thoracoscopic segmentectomy.Among them,19 patients used preoperative CT-guided Hookwire to locate lung nodules and set them as the positioning group;the other 24 patients did not take preoperative CT-guided Hookwire positioning is set as the control group.Statistical analysis of clinical data of patients during the perioperative period,including: the diameter of the lesion,the distance between the margin of the lesion and the parietal pleura,the location,the surgical margin(generally ≥ 2cm),the time to find the lesion after surgery,the operation time,postoperative complications,postoperative pathology,etc.Result : The time of searching for lesions and the total length of surgery in the positioning group were lower than those of the control group;the time of searching for lesions in the positioning group(4.2 ± 2.3)min was lower than that of the control group(10.7 ± 8.4)min,(P <0.05);the total operation time of the positioning group(197.79 ±46.12)min was lower than the total operation time of the control group(216.35 ± 53.34)min,(P <0.05);The cutting edge distance of the positioning group(2.94 ± 0.68)cm is larger than that of the control group(2.75 ± 0.85)cm,but the difference between the two groups is not statistically significant(P> 0.05);There was no statistically significant difference between the two groups in the amount of intraoperative bleeding,the time of indwelling chest tube after surgery,the length of hospital stay after surgery,and the incidence of postoperative complications(P> 0.05).Conclusion : In the treatment of patients with pulmonary nodules through thoracoscopic segmentectomy,Hookwire positioning under CT guidance before surgery can provide some guidance for accurate intraoperative detection of lesions,and has certain advantages in shortening the time of thoracoscopy surgery.