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@#Objective To investigate the feasibility of using magnetic beads to locate small pulmonary nodules. Methods Twelve rabbits were randomly divided into two groups, 6 in each group. One group underwent thoracotomy after anesthesia and the other group underwent percutaneous puncture under the guidance of X-ray. One and two cylindrical tracer magnets (magnetic beads) with a diameter of 1 mm and a height of 3 mm were injected adjacent to the imaginary pulmonary nodules in left lung in each group. The magnetic beads beside the imaginary nodules were attracted by a pursuit magnet with a diameter of 9 mm and a height of 19 mm. The effectiveness of localization by magnetic beads were determined by attraction between tracer and pursuit magnets. Results All processes were uneven in 12 rabbits. There was micro hemorrhage and no hematoma in the lung tissue at the injection site of the magnetic beads. When tracked with the pursuit magnets, there was one bead divorce in cases that one bead was injected, but no migration or divorce of the magnetic beads in cases that two magnetic beads were simultaneously injected to localize the small pulmonary nodules. Conclusion The feasibility of using magnetic beads to locate small pulmonary nodules has been preliminarily verified.
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@#Objective To explore the safety and effectiveness of a precise marking method based on body surface mesh and three-dimensional (3D) image reconstruction. Methods We retrospectively analyzed the clinical data of 22 patients in our hospital from October 2018 to October 2019. There were 13 males and 9 females aged 58.5 (37-72) years. All patients underwent a precise marking of pulmonary nodules based on body surface mesh and 3D image reconstruction. Then, video-assisted thoracoscopic surgery (VATS) was performed to resect the nodules. The clinical data, including positioning success rate and operation time were analyzed. Results A total of 22 small pulmonary nodules were removed. The average diameter of small nodules was 12±3 mm, and the average distance from the visceral pleura was 17±6 mm. The localization success rate was 86.4%. The operation time was 110±43 min, and there was no surgery-related complication. Conclusion The method of marking pulmonary nodules based on body surface mesh and 3D image reconstruction is a safe and reliable technology, which reduces the risk of hemopneumothorax caused by CT-guided lung puncture.
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Objective To investigate the status of pulmonary nodules management in central hospital of Shanghai Putuo District. Methods In 2016 and 2017, patients with solitary pulmonary nodules found by low-dose spiral CT were selected during the initial physical examination in Putuo District Central Hospital of Shanghai. The pulmonary nodules were 4-8 mm in diameter and aged 30-85 years. The patients with pulmonary nodules in 2016 were the control group, and only routine management was carried out. The patients with pulmonary nodules in 2017 were in the health management group. Health records were established, health education was carried out, and follow-up was carried out. After one year of comparative intervention, the effect of health management of pulmonary nodules was evaluated in the two groups by their awareness of pulmonary nodules, negative psychological status, follow-up and the number of pulmonary nodules diagnosed as lung cancer by dynamic changes in pulmonary nodules during one year of follow-up. Results The detection rates of the pulmonary nodules were 11.2% (4 361/38 793) and 12.1% (5 056/41 482) in the first physical examination population in 2016 and 2017, respectively, with no significant difference (χ2=29.641, P=0.128). The control group included 4 361 cases and the health management group included 5 056 cases. The follow-up rate of health management group was 78.0% (2 878 cases) higher than that of the control group (66.0%, 3 944 cases). The difference was statistically significant (χ2 =4.174, P=0.016). In the health management group, 4 651 patients (95.4%) had comprehensive knowledge of pulmonary nodules, higher than 1 820 patients (44.6%) in the control group (χ2=10.363, P=0.078). There were 1 213 (24.9%) patients with negative psychology such as panic and anxiety in the health management group, which was lower than 3 303 (81.0%) patients in the control group (χ2=6.414, P=0.102). During the follow-up period of the following year, 37 cases (0.7%) in the health management group were diagnosed as early lung cancer due to the dynamic changes of small nodules, and 19 cases (0.4%) in the control group. The difference was statistically significant (χ2=4.093, P<0.05). Conclusion Health management of patients with pulmonary nodules can improve their awareness of pulmonary nodules , reduce their negative psychology and increase the detection rate of early lung cancer. Health management of pulmonary nodules is valuable for early detection of lung cancer.
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Objective To analyze the value of endobronchial ultrasound-guided ultrathin bronchoscope(EUGUB) and methylene blue positioning video-assisted thoracoscopic surgery(VATS) for small pulmonary nodules.Methods Sixty patients undergoing VATS, using pre-operative EUGUB combination with methylene blue was performed .The positioning accuracy, the complications and pathological classification were analyzed .Results EUGUB combination with methylene blue positioning ac-curacy was 91.7%, meanwhile, 2 patients with hemoptysis with no conservative treatment.The postoperative histological pa-thology results showed that benign lesions and malignant lesions accounted for 28.3% and 71.7%, respectively.Conclusion The method of EUGUB combination with methylene blue in positioning of the small pulmonary nodules increases the achieve-ment ratio of VATS with few complications, and may be widely used in treatment of small pulmonary nodules with VATS.
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Objective To evaluate the clinical application of CT-guided localization with combination of methylene blue and a Hookwire system for small pulmonary nodules (SPNs) before video-assisted thoracoscopic resection.Methods CTguided localization the SPNs before resection in 56 patients and 60 nodules,then underwent video-assisted thoracic surgery (VATS) resection.Among 56 patients,19 males and 37 females,aged from 35 to 81 years,mean age was (61.1 ±8.9)years.Results SPNs diameter (6.80 ±4.12) mm,distance from the parietal pleura (15.38 ±4.63) mm.CT-guided localization success rate was 100％,positioning time (10.76 ± 8.17) min,8.9％ (5/56) had micro pneumothorax aftet positioning,7.1％ (4/56) occurrence of needle tract bleeding,no conservative treatment.VATS resection rate was 100％.The pathology of 60 lesions were shown:Bronchiolo-alveolar carcinoma(BAC) were 33 lesions(55.0％),BAC and adenocarcinoma were 11 lesions(18.3％),Atypicaladenomatous hyperplasia (AAH) were 7 lesions (11.8％),Inflammation were 4 lesions (6.7％),Harmatoma were 3 lesions(5.0％),Tuberculoses were 2 lesions(3.3％).Conclusion CT-guided localization with combination of methylene blue and a Hookwire system before video-assisted thoracoscopic resection is a promising technique for small solitary pulmonary nodules.It could play an important role in accurate localization of small pulmonary nodules,and it is a safe technique with clinical application.
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Objective To investigate the efficacy of video-assisted thoracic small incision in diagnosis and treatment of small pulmonary nodules.Methods From February 2007 to February 2008,53 patients(aged over 40 years) with small solitary pulmonary nodule(≤3 cm in diameter) were treated by video-assisted thoracoscopy via a small incision.The nodules were removed during the operation,and then based on the results of quick pathological examination,malignant cases received further surgeries.Results Totally 39 patients were diagnosed with malignant disease,34 of them received small-incision radical lobectomy for primary lung cancer,small-incision resection of the lesions were performed on 5 patients who had bilateral(2 cases) or metastatic lung cancer(3 cases).Benign lesions were confirmed in 14 patients during the operation,and were removed by local resection.All of the patients with primary lung cancer,except one,achieved an mean of 7 months follow-up(ranged 2 to 12 months),31 of the patients survived without tumor during the period;2 patients showed recurrent cancer in 6 months after the operation,and thus received lobectomy.The 2 patients who had bilateral lung cancer and the 3 cases of metastatic lung cancer died in 2 to 6 months(mean,4 months) after the surgery.The 14 benign cases were followed up for 3 to 12 months(mean,7.5 months),none of them had recurrence.Conclusion Video-assisted thoracic small incision is effective in the diagnose and treatment of small pulmonary nodules.
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Diffuse panbronchiolitis is a chronic inflammatory lung disease of unknown etiology which is characterized by chronic airflow limitation and airway inflammation, predominantly localized in the respiratory bronchioles with infiltration of inflammatory cells, and has typical clinical, radiological and pathological features. Obstructive respiratory functional impairment, occasional symptoms of wheezing, and also cough and sputum resemble the feature of emphysema, bronchial asthma, or chronic bronchitis, respectively. We experienced a case of pathologically proven advanced diffuse panbronchiolitis in a 55-year-old man with productive cough and exertional dyspnea. The chest radiography showed multiple tiny nodular densities on whole lung fields. It was confirmed by thoracoscopy-guided lung biopsy and the patient was improved after initiation of treatment with low-dose erythromycin