微小肺部病灶之術中定位

10.6666/ClinMed.202106_87(6).0059

劉佳；簡宏哲

肺癌（lung cancer） ； 肺結節（lung nodule） ； 毛玻璃樣病灶（ground-glass opacity lesion） ； 術前定位（pre-operatively localization） ； 術中定位（intra-operatively localization）

臨床醫學月刊

87卷6期（2021 / 06 / 25）

354 - 359

繁體中文

肺癌為國人第一大癌症死因，早期診斷及治療是降低癌症死亡的關鍵。低劑量電腦斷層檢查的普及讓我們能更早發現肺部異常的變化。由於早期發現的病灶通常體積較小或非實質結構，手術中確認病灶位置並完整切除便成為有效治療的關鍵。為了避免犧牲過多健康肺組織，保障患者術後肺功能，執行胸腔鏡手術前的精準定位，在微小肺病灶的手術治療中就扮演十分重要的角色。術前，於電腦斷層室先定位再移置手術室開刀的方式已行之有年；除此，術中定位如混成手術室定位、電磁導航定位、術中超音波定位等方式亦逐漸普及。

1. Anderson, IJ,Davis, AM(2018).Incidental Pulmonary Nodules Detected on CT Images.JAMA,320,2260-2261.
2. Borghesi, A,Michelini, S,Nocivelli, G(2019).Solid Indeterminate Pulmonary Nodules Less Than or Equal to 250 mm(3): Application of the Updated Fleischner Society Guidelines in Clinical Practice.Radiol Res Pract,2019,1-7.
3. Brown, J,Lee, TJ,Joiner, T,Wrightson, W(2016).Using Electromagnetic Navigation Bronchoscopy and Dye Injection to Aid in Video-Assisted Lung Resection.Am Surg,82,1052-1054.
4. Cornella, KN,Repper, DC,Palafox, BA(2021).A Surgeon's Guide for Various Lung Nodule Localization Techniques and the Newest Technologies.Innovations,16,26-33.
5. Keating, J,Singhal, S(2016).Novel Methods of Intraoperative Localization and Margin Assessment of Pulmonary Nodules.Semin Thorac Cardiovasc Surg,28,127-136.
6. Lin, MW,Chen, JS(2016).Image-guided techniques for localizing pulmonary nodules in thoracoscopic surgery.J Thorac Dis,8,S749-S755.
7. Liu, B,Gu, C.(2020).Expert consensus workshop report: Guidelines for preoperative assisted localization of small pulmonary nodules.J Cancer Res Ther,16,967-973.
8. Loverdos, K,Fotiadis, A,Kontogianni, C(2019).Lung nodules: A comprehensive review on current approach and management.Ann Thorac Med,14,226-238.
9. MacMahon, Heber,Naidich, David P.,Goo, Jin Mo(2017).Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017.Radiology,284,228-243.
10. Nardini, M,Dunning, J(2020).Pulmonary nodules precision localization techniques.Future oncology,16,15-19.
11. National Lung Screening Trial Research Team,Aberle, DR,Adams, AM(2011).Reduced lung-cancer mortality with low-dose computed tomographic screening.N Eng J Med,365,395-409.
12. Suzuki, K,Nagai, K,Yoshida, J(1999).Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking.Chest,115,563-568.