Advance in lung cancer surgery
作者： Mark W. Hennon , Sai Yendamuri
DOI: 10.3779/J.ISSN.1009-3419.2013.03.11
关键词:
摘要: 术中超声定位肺结节 实施胸腔镜切除时定位肺结节的难易程度取决于病 变的大小和部位。传统上,定位中央型、周围型肺结节的 金标准是触诊,这需要借助于开胸术。在胸腔镜下无法进 行触诊,这是一个固有缺陷。胸腔镜下对比较困难的结节 进行操作时,提高成功率的其它选择包括通过如导航支气 管镜等方法进行图像引导下针吸定位、基准标记安置或者 墨汁染色法。这些方法的潜在缺陷包括额外的术前准备时 间、气胸的风险、针头移位或分离术侧肺时发送移位以及 靶向肺区域的非特异性墨水染色。 在电视辅助胸腔镜手术(video-assisted thoracoscopic surgery, VATS)中,术中超声已成为术中检测肺结节的一 个切实可行的选择。利用一个可弯曲的腹腔镜10 mm超声 探头(B-K Medical, Herlev, Denmark)和用于肺检查的导电 膏,传统VATS技术检测不到的病变均可被检测到并定位。 一旦识别,借助于标准楔形切除技术可将病变切除。介绍
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