Application comparison of CT-guided localization with medical glue or puncture needle for pulmonary ground-glass nodules before thoracoscopic resection / 肿瘤研究与临床

Objective:To investigate the application value of CT-guided localization with medical glue or puncture needle before thoracoscopic pulmonary ground-glass nodule resection.Methods:The clinical data of 92 patients who underwent localization before thoracoscopic resection of pulmonary ground-glass nodules in Beijing Chao-Yang Hospital from June 2019 to November 2022 were retrospectively analyzed. According to the preoperative localization method, the patients were divided into puncture needle group (52 cases) and medical glue group (40 cases). The localization success rate, localization time and incidence rate of complications were compared between the two groups.Results:The success rate of localization in both groups was 100%. In puncture needle group, the guide wire of 1 case (1.9%) prolapsed, but it did not affect the surgical resection. The localization time of puncture needle group and medical glue group was (18±6) min and(14±5) min, and there was a statistical difference between the two groups ( t = 3.06, P = 0.003). The incidence of bleeding and pneumothorax in medical glue group was lower than that in puncture needle group [12.5% (5/40) vs. 38.5% (20/52), χ2 = 7.70, P = 0.009; 35.0% (14/40) vs. 71.2% (37/52), χ2 = 11.96, P = 0.001]. The incidence rate of irritating cough in was higher than that in puncture needle group [50.0% (20/40) vs. 11.5% (6/52), χ2 = 16.50, P < 0.05]. Conclusions:CT-guided localization with medical glue or puncture needle can achieve satisfactory results in the localization of pulmonary ground-glass nodule before thoracoscopic resection and help to improve the accuracy of surgical resection. The incidence rates of bleeding and pneumothorax of medical glue localization are lower than those of puncture needle localization.

Preoperative localization indication of clinical peripheral pulmonary ground-glass nodules by Da Vinci robot surgery / 中国胸心血管外科临床杂志

@#Objective    To investigate the preoperative localization of pulmonary glabrous nodules. Methods    A total of 192 patients admitted to General Hospital of  Northern Theater Command from April 2012 to September 2019 were selected for the study. There were 95 males and 97 females at an age of 56.47±11.79 years. All patients completed preoperative examination, and were divided into a positioning group (n=97) and a non-positioning group (n=95) according to whether the preoperative positioning was performed. And the surgical indicators between the two groups were compared. According to the substance of ground-glass opacity, they were divided into a pure ground-glass nodules group (n=23) and a mixed ground-glass nodules group (n=74) in the positioning group and a pure ground-glass nodules group (n=14) and a mixed ground-glass nodules group (n=81) in the non-positioning group . According to the size and distance of the nodules from the pleura and whether the nodules could be detected, the corresponding linear function was obtained. Results    The operative time of methylene blue localization group was shorter than that of the no localization group. In the scatter plot, the corresponding diameter and depth of the nodules and the corresponding coordinate points which can be explored were described. And linear regression was performed on all the coordinate points to obtain the linear function: depth=0.648×diameter–1.446 (mm). It can be used as an indication for the preoperative localization of pure ground-glass nodules in Da Vinci robotic surgery. Linear function: depth=0.559 5×diameter+0.56 (mm). It can be used as an indication of preoperative localization of mixed ground-glass nodules in Da Vinci robotic surgery. Conclusion    This equation can be used as a preoperative indication for clinical peripheral pulmonary ground-glass nodules.

Management Strategies of Pulmonary Ground Galss Nodule / 中国肺癌杂志

Pulmonary ground glass nodule (GGN) is a term of radiological manifestation, which may be malignant or benign. The management for pulmonary GGN remains controversial. Both Fleischner society and National Comprehensive Cancer Network (NCCN) panel updated the guideline for the management of GGN in 2017. Compared with previous versions, the indication for surgery or biopsy is stricter, and the recommended follow-up interval is prolonged. In clinical practice, the size of GGN component, the size of consolidation component, dynamic change during follow-up and computed tomography (CT) value are the four factors that help surgeons to decide the timing of surgery. There are some misunderstandings for the management of GGN, such as the administration of antibiotics, the use of positron emission tomography-computed tomography (PET-CT), pure GGN adjacent to visceral pleura, and GGN with penetrating vessel. In conclusion, GGN is a kind of slowly growing lesion, which can be followed up safely.
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Diagnostic value of CT thin-section target reconstruction technique in patients with pulmonary small size ground glass nodules / 实用放射学杂志

Objective To investigate the diagnostic value of CT thin-section target reconstruction technique in patients with pulmonary small size groud glass nodules (sGGN).Methods A total of 109 patients with pulmonary sGGN certified post-operation and/or follow up were analyzed retrospectively,and the clinical and CT images of all patients were completely collected.There were 23 cases of benign group,21 cases of adenocarcinoma in situ group,29 cases of minimally invasive adenocarcinoma group and 36 cases of invasive adenocarcinoma group,respectively.The differential diagnostic value using CT thin-section target reconstruction technique was analyzed between the benign and malignant pulmonary sGGN groups,and the CT feature detection rates were compared between CT thin section target and common reconstruction techniques.Results The CT thin-section target reconstruction technique had improved the diagnostic efficiency of pulmonary sGGN.The diagnostic accuracy,area under curve(AUC),sensitivity and specificity were 85.32 ％,0.679,90.80 ％,63.64 ％ in malignant group and 77.06％,0.764,83.72％,52.17％ in benign pulmonary sGGN group,respectively.The CT features as solid component in whole nodule,"halo sign",speculation sign,pleural retraction sign,lobulation sign were more detected by using the thin-section target reconstruction technique than that by using the common reconstruction among adenocarcinoma in situ group,minimally invasive adenocarcinoma group and invasive adenocarcinoma group (P＜0.05) but not speculation sign in the invasive adenocarcinoma group(P=0.126).Conclusion The CT thin section target reconstruction technique can improve the diagnostic value of pulmonary sGGN.