CAJ | 학술논문

目的：总结全胸腔镜手术对肺部亚厘米结节的诊治经验。方法对一组CT诊断怀疑为恶性的肺部孤立性结节病例（38例）进行回顾性分析，总结Hookwire定位、胸腔镜手术的围术期资料，并对亚厘米结节的病理结果作一总结分析。结果所有结节借助Hookwire能明确定位，无严重并发症；全组均顺利完成手术，包括楔形切除术24例，肺段切除术4例，肺叶切除及淋巴结清扫术10例。中转开胸2例，无围术期死亡，术后均获得明确诊断；其中浸润性癌15例，浸润前病变5例，转移瘤2例，良性病变16例。冰冻病理与石蜡病理的符合率为92．1％。结论采用全胸腔镜手术对肺部亚厘米结节的进行术前检查是一项安全、有效的诊断或治疗手段。
목적：총결전흉강경수술대폐부아전미결절적진치경험。방법대일조CT진단부의위악성적폐부고립성결절병례（38례）진행회고성분석，총결Hookwire정위、흉강경수술적위술기자료，병대아전미결절적병리결과작일총결분석。결과소유결절차조Hookwire능명학정위，무엄중병발증；전조균순리완성수술，포괄설형절제술24례，폐단절제술4례，폐협절제급림파결청소술10례。중전개흉2례，무위술기사망，술후균획득명학진단；기중침윤성암15례，침윤전병변5례，전이류2례，량성병변16례。빙동병리여석사병리적부합솔위92．1％。결론채용전흉강경수술대폐부아전미결절적진행술전검사시일항안전、유효적진단혹치료수단。
Objective To summarize the diagnostic and therapic experence of video-assisted thoracoscopic surgery for subcentimeter pulmonary nodules. Methods Thirty-eight patients with subcent-imeter pulmonary nodules highly suggested of a malignancy by CT scan were retrospectively analyzed. Perioperative period data about hookwire location and video-assisted thoracoscopic surgery was summarized..Pathological results of the subcentimeter pulmonary nodules was analyzed. Results All lesions were successfully identified by the hookwire approach..All the operations were completed with no serious complication,.including wedge resection in 24 cases, segmentectomy in 4 and lobectomy with lymph node dissection in 10..Pathological diagnosis identified 15 invasive carcinomas,.5 pre-invasive carcinomas, 2 metastatic tumors and 16 benign lesions..The pathological coincidence rate between frozen section and paraffin section was 92.1%..Conclusion Subcentimeter pulmonary nodules are difficultly diagnosed in preoperative and intranperative period. .Video-assisted thoracoscopic surgery is one of the effective and safe techniques for the diagnosis and therapy of subcentimeter pulmonary nodules.