Thoracic Surgery, Video-Assisted Clinical Trial
Official title:
Preoperative Stereoscopic Localization Versus Methylene Blue Localization in GGO Patients With Lung Wedge Resection:A Prospective Self-control Study.
This study evaluates the feasibility,accuracy and safety of Preoperative Stereoscopic Localization Versus Methylene Blue Localization in GGO Wedge Resection. In the first stage,participants will receive both Preoperative Stereoscopic Localization and Methylene Blue Localization .In the second stage,participants only receive Preoperative Stereoscopic Localization for Wedge Resection.
More and more Ground Glass Opacity(GGO)are detected because of the early screening.According
to Fleischner Society, for some solid GGO, surgical resection should be performed if the
solid component is larger than 5mm.With the development of video-assisted thoracoscopic
surgery (VATS) techniques, minimally invasive thoracic surgery has evolved considerably over
the last three decades.However, localizing the small sized pulmonary nodules during VATS is
challenging when there is no change in visceral pleura.
Several traditional techniques have been described to localize peripheral pulmonary nodules,
including preoperative CT-guided tattooing with methylene blue, CT scan guided spiral/hook
wire placement and marking with radio-opaque materials. The traditional marking method have
its strong and weak points. For the strong point, It provide a credible and precise nodule
location to the surgeon. For the weak points:(1)a potential risk of pneumothorax and
hemothorax.(2)Methylene blue have a tendency to diffuse over a large area during surgical
preparation until the nodule's location is confirmed.(3)The Preoperative localization
technique would need more time for the Preoperative preparation, which would be reduce the
transport's efficiency.(4)It would occupy the resource of CT's usage.(5)Some of the methods
,such as methylene blue, maybe interference with the Pathological diagnosis.(6)These methods
are all invasive operation, would Cause the patients' psychological fear.
In order to avoid these weak points,the investigators use a new localization technique which
has three basic steps: 1.Confirm the nodule's location in pulmonary segments. 2.Measure the
distance between the nodule and anatomic landmarks on CT. 3. Estimate the changes of the
distance between the nodule and anatomic landmarks after the alveolar atelectasis. The
investigators have already succeed in some case.But,the further study is needed.Hence,the
investigators designed a prospective study of Preoperative Stereoscopic Localization Versus
Methylene Blue Localization in GGO Wedge Resection.Then,the investigators evaluate the
feasibility,accuracy and safety of Preoperative Stereoscopic Localization Versus Methylene
Blue Localization in GGO Wedge Resection.
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