三维（3D）重建在电视胸腔镜下下肺叶复杂节段切除术治疗中的应用：一项回顾性研究。
Application of three-dimensional (3D) reconstruction in the treatment of video-assisted thoracoscopic complex segmentectomy of the lower lung lobe: A retrospective study.
作者信息
Wang Xinyu, Wang Qing, Zhang Xindi, Yin Hang, Fu Yujie, Cao Min, Zhao Xiaojing
机构信息
Department of Thoracic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
Front Surg. 2022 Sep 29;9:968199. doi: 10.3389/fsurg.2022.968199. eCollection 2022.
BACKGROUND
An increasing number of lung ground-glass nodules (GGNs) have been detected ever since low-dose computer tomography started growing in popularity. Three-dimensional (3D) reconstruction technology plays a critical role in lung resection, especially in segmentectomy. In this study, we explore the role of 3D reconstruction in thoracoscopic complex segmentectomy of lower lung lobe.
METHODS
A total of 97 patients who underwent complex segmentectomy of lower lung lobe from January 2021 to March 2022 were retrospectively analyzed. We divided these patients into a 3D group ( = 42) and a routine group ( = 55) based on preoperative 3D reconstruction or without this procedure. The demographics of patients and GGNs were collected and perioperative outcomes were compared between the two groups.
RESULTS
All of the baseline characteristics between the groups were comparable (all > 0.05). There was no 30-day postoperative mortality and conversion in the two groups. The operation time of the 3D group was significantly shorter than that of the routine group (111.4 ± 20.8 min vs. 127.1 ± 32.3 min, = 0.007). The number of stapler reloads during surgery in the 3D group was less than that in the routine group (9.0 ± 2.2 vs. 10.4 ± 2.6, = 0.009). The rate of air leakage on postoperative days 1-3 was lower in the 3D group (11.9% vs. 30.9%, = 0.027). In addition, the resection margins of all patients in the 3D group were adequate, while four patients in the routine group had inadequate resection margins, although there was no statistically significant difference ( = 0.131). Intraoperative blood loss, postoperative drainage, postoperative hospital stay, pneumonia/atelectasis, and hemoptysis were similar between the two groups.
CONCLUSIONS
For performing complex segmentectomy of the lower lung lobe, the procedure of 3D reconstruction may shorten the operation time, decrease the number of stapler reloads, prevent postoperative air leakage, and guarantee a safe surgical margin. Therefore, 3D reconstruction is recommended for complex segmentectomy of the lower lung lobe.
背景
自从低剂量计算机断层扫描开始普及以来，越来越多的肺部磨玻璃结节（GGN）被检测出来。三维（3D）重建技术在肺切除术中起着关键作用，尤其是在肺段切除术中。在本研究中，我们探讨了3D重建在下肺叶胸腔镜复杂肺段切除术中的作用。
方法
回顾性分析2021年1月至2022年3月期间接受下肺叶复杂肺段切除术的97例患者。根据术前是否进行3D重建，将这些患者分为3D组（n = 42）和常规组（n = 55）。收集患者和GGN的人口统计学数据，并比较两组的围手术期结果。
结果
两组之间所有的基线特征具有可比性（均P > 0.05）。两组均无术后30天死亡率和中转情况。3D组的手术时间明显短于常规组（111.4±20.8分钟 vs. 127.1±32.3分钟，P = 0.007）。3D组手术中吻合器重新装填的次数少于常规组（9.0±2.2次 vs. 10.4±2.6次，P = 0.009）。3D组术后1 - 3天的漏气率较低（11.9% vs. 30.9%，P = 0.027）。此外，3D组所有患者的切缘均足够，而常规组有4例患者切缘不足，尽管差异无统计学意义（P = 0.131）。两组之间术中出血量、术后引流量、术后住院时间、肺炎/肺不张和咯血情况相似。
结论
对于进行下肺叶复杂肺段切除术，3D重建程序可能会缩短手术时间，减少吻合器重新装填的次数，防止术后漏气，并保证安全的手术切缘。因此，推荐对下肺叶复杂肺段切除术采用3D重建。
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