在切的肺样本中,基于计算机断层扫描的术内外科手术边缘评估的实用性
Takahiro Yanagihara1,2, Kentaro Miura1, Nicholas Bernards1
1Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
概括
肺样本的手术内计算机断层扫描 (CT) 在切割过程中提供了可靠的外科边缘评估. 这种方法提供了比外科医生评估更准确的估计,可能改善患者的结果.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 医疗成像医学成像
背景情况:
- 适当的外科边缘对于下叶膜肺切除至关重要.
- 之前的研究表明,计算机断层扫描 (CT) 对切除的肺样本进行边缘评估的可行性.
研究的目的:
- 评估手术内CT图像反的可靠性和影响,用于肺切割手术决策.
主要方法:
- 来自61名接受治疗切除的患者的70个肺样本被充气并使用CT扫描.
- CT图像与外科医生分享,以指导对额外管理的决定.
- 外科医生的边际估计 (estiMargin) 在切割前和后记录下来.
主要成果:
- CT测量的边缘与病理边缘 (pathMargins) 密切一致 (偏差为0.6毫米,r=0.75).
- 外科医生的切割前和切割后估计远远长于路径边缘 (p < 0.01).
- 在7.4%的肺癌病例中,外科CT影响了外科决定.
结论:
- 基于CT的边缘评估提供了对病理边缘的及时和可靠的手术内估计.
- 这种方法比外科医生的估计更准确,并且可以在切割中确保更充分的边缘.
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