Cargando…

胸腔镜治疗肺部微小结节(129例报告)

BACKGROUND AND OBJECTIVE: The development of image technology has led to increasing detection of pulmonary small nodules year by year, but the determination of their nature before operation is difficult. This clinical study aimed to investigate the necessity and feasibility of surgical resection of...

Descripción completa

Detalles Bibliográficos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 中国肺癌杂志编辑部 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973285/
https://www.ncbi.nlm.nih.gov/pubmed/28103971
http://dx.doi.org/10.3779/j.issn.1009-3419.2017.01.05
_version_ 1783326583746985984
collection PubMed
description BACKGROUND AND OBJECTIVE: The development of image technology has led to increasing detection of pulmonary small nodules year by year, but the determination of their nature before operation is difficult. This clinical study aimed to investigate the necessity and feasibility of surgical resection of pulmonary small nodules through a minimally invasive approach and the operational manner of non-small cell lung cancer (NSCLC). METHODS: The clinical data of 129 cases with pulmonary small nodule of 10 mm or less in diameter were retrospectively analyzed in our hospital from December 2013 to November 2016. Thin-section computed tomography (CT) was performed on all cases with 129 pulmonary small nodules. CT-guided hook-wire precise localization was performed on 21 cases. Lobectomy, wedge resection, and segmentectomy with lymph node dissection might be performed in patients according to physical condition. RESULTS: Results of the pathological examination of 37 solid pulmonary nodules (SPNs) revealed 3 primary squamous cell lung cancers, 3 invasive adenocarcinomas (IAs), 2 metastatic cancers, 2 small cell lung cancers (SCLCs), 16 hamartomas, and 12 nonspecific chronic inflammations. The results of pathological examination of 49 mixed ground glass opacities revealed 19 IAs, 6 micro invasive adenocarcinomas (MIAs), 4 adenocarcinomas in situ (AIS), 1 atypical adenomatous hyperplasia (AAH), 1 SCLC, and 18 nonspecific chronic inflammations. The results of pathological examination of 43 pure ground glass opacities revealed 19 AIS, 6 MIAs, 6 IA, 6 AAHs, and 6 nonspecific chronic inflammations. Wedge resection under video-assisted thoracoscopic surgery (VATS) was performed in patients with 52 benign pulmonary small nodules. Lobectomy and systematic lymph node dissection under VATS were performed in 33 patients with NSCLC. Segmentectomy with selective lymph node dissection, wedge resection, and selective lymph node dissection under VATS were performed in six patients with NSCLC. Two patients received secondary lobectomy and systematic lymph node dissection under VATS because of intraoperative frozen pathologic error that happened in six cases. Two cases of N2 lymph node metastasis were found in patients with SPN of IA. CONCLUSION: Positive surgical treatment should be taken on patients with persistent pulmonary small nodules, especially ground glass opacity, because they have a high rate of malignant lesions. During the perioperative period, surgeons should fully inform the patients and family members that error exist in frozen pathologic results to avoid medical disputes.
format Online
Article
Text
id pubmed-5973285
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher 中国肺癌杂志编辑部
record_format MEDLINE/PubMed
spelling pubmed-59732852018-07-06 胸腔镜治疗肺部微小结节(129例报告) Zhongguo Fei Ai Za Zhi 临床研究 BACKGROUND AND OBJECTIVE: The development of image technology has led to increasing detection of pulmonary small nodules year by year, but the determination of their nature before operation is difficult. This clinical study aimed to investigate the necessity and feasibility of surgical resection of pulmonary small nodules through a minimally invasive approach and the operational manner of non-small cell lung cancer (NSCLC). METHODS: The clinical data of 129 cases with pulmonary small nodule of 10 mm or less in diameter were retrospectively analyzed in our hospital from December 2013 to November 2016. Thin-section computed tomography (CT) was performed on all cases with 129 pulmonary small nodules. CT-guided hook-wire precise localization was performed on 21 cases. Lobectomy, wedge resection, and segmentectomy with lymph node dissection might be performed in patients according to physical condition. RESULTS: Results of the pathological examination of 37 solid pulmonary nodules (SPNs) revealed 3 primary squamous cell lung cancers, 3 invasive adenocarcinomas (IAs), 2 metastatic cancers, 2 small cell lung cancers (SCLCs), 16 hamartomas, and 12 nonspecific chronic inflammations. The results of pathological examination of 49 mixed ground glass opacities revealed 19 IAs, 6 micro invasive adenocarcinomas (MIAs), 4 adenocarcinomas in situ (AIS), 1 atypical adenomatous hyperplasia (AAH), 1 SCLC, and 18 nonspecific chronic inflammations. The results of pathological examination of 43 pure ground glass opacities revealed 19 AIS, 6 MIAs, 6 IA, 6 AAHs, and 6 nonspecific chronic inflammations. Wedge resection under video-assisted thoracoscopic surgery (VATS) was performed in patients with 52 benign pulmonary small nodules. Lobectomy and systematic lymph node dissection under VATS were performed in 33 patients with NSCLC. Segmentectomy with selective lymph node dissection, wedge resection, and selective lymph node dissection under VATS were performed in six patients with NSCLC. Two patients received secondary lobectomy and systematic lymph node dissection under VATS because of intraoperative frozen pathologic error that happened in six cases. Two cases of N2 lymph node metastasis were found in patients with SPN of IA. CONCLUSION: Positive surgical treatment should be taken on patients with persistent pulmonary small nodules, especially ground glass opacity, because they have a high rate of malignant lesions. During the perioperative period, surgeons should fully inform the patients and family members that error exist in frozen pathologic results to avoid medical disputes. 中国肺癌杂志编辑部 2017-01-20 /pmc/articles/PMC5973285/ /pubmed/28103971 http://dx.doi.org/10.3779/j.issn.1009-3419.2017.01.05 Text en 版权所有©《中国肺癌杂志》编辑部2017 https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) License. See: https://creativecommons.org/licenses/by/3.0/
spellingShingle 临床研究
胸腔镜治疗肺部微小结节(129例报告)
title 胸腔镜治疗肺部微小结节(129例报告)
title_full 胸腔镜治疗肺部微小结节(129例报告)
title_fullStr 胸腔镜治疗肺部微小结节(129例报告)
title_full_unstemmed 胸腔镜治疗肺部微小结节(129例报告)
title_short 胸腔镜治疗肺部微小结节(129例报告)
title_sort 胸腔镜治疗肺部微小结节(129例报告)
topic 临床研究
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973285/
https://www.ncbi.nlm.nih.gov/pubmed/28103971
http://dx.doi.org/10.3779/j.issn.1009-3419.2017.01.05
work_keys_str_mv AT xiōngqiāngjìngzhìliáofèibùwēixiǎojiéjié129lìbàogào
AT xiōngqiāngjìngzhìliáofèibùwēixiǎojiéjié129lìbàogào
AT xiōngqiāngjìngzhìliáofèibùwēixiǎojiéjié129lìbàogào
AT xiōngqiāngjìngzhìliáofèibùwēixiǎojiéjié129lìbàogào
AT xiōngqiāngjìngzhìliáofèibùwēixiǎojiéjié129lìbàogào
AT xiōngqiāngjìngzhìliáofèibùwēixiǎojiéjié129lìbàogào
AT xiōngqiāngjìngzhìliáofèibùwēixiǎojiéjié129lìbàogào
AT xiōngqiāngjìngzhìliáofèibùwēixiǎojiéjié129lìbàogào
AT xiōngqiāngjìngzhìliáofèibùwēixiǎojiéjié129lìbàogào
AT xiōngqiāngjìngzhìliáofèibùwēixiǎojiéjié129lìbàogào