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三维计算机断层扫描支气管造影和血管造影联合灌注区域识别技术在单孔胸腔镜复杂肺段切除术中的应用

[Application of Three-dimensional Computed Tomography Bronchography and 
Angiography Combined with Perfusion Area Identification Technique 
in Uniport Thoracoscopic Complex Segmentectomy].

作者信息

Li Yuanbo, Zhang Yi, Zhi Xiuyi, Su Lei, Liu Baodong

机构信息

Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2023 Jan 20;26(1):17-21. doi: 10.3779/j.issn.1009-3419.2023.101.02.

Abstract

BACKGROUND

With the extensive application of segmental lung resection in the treatment of early-stage lung cancer, how to complete segmentectomy more accurately and minimally invasively has become a research hotspot. The aim of this study is to explore the application of three-dimensional computed tomography bronchography and angiography (3D-CTBA) combined with perfusion area recognition technique in single-hole thoracoscopic complex segmentectomy.

METHODS

From January 2021 to January 2022, the clinical data of 112 consecutive patients undergoing single-port thoracoscopic complex segmentectomy in the Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University were retrospectively analyzed. The three-dimensional reconstruction combined with perfusion area identification technique was used to perform the operation and the clinical data were analyzed.

RESULTS

The average operation time was (141.1±35.4) min; the initial time of intersegmental plane display was (12.5±1.7) s; the maintenance time of intersegmental plane was (114.3±10.9) s; the intersegmental plane was clearly displayed (100%); the amount of bleeding was [10 (10, 20)] mL; the total postoperative drainage volume was (380.5±139.7) mL; the postoperative extubation time was (3.9±1.2) d; and the postoperative hospitalization time was (5.2±1.6) d. Postoperative complications occurred in 8 cases.

CONCLUSIONS

The advantages of 3D-CTBA combined with perfusion area recognition technique are fast, accurate and safe in identifying intersegmental boundary in single-port thoracoscopic complex segmentectomy, which could provide guidances for accuratding resection of tumors, shortening operation time and reducing surgical complications.

摘要

背景

随着肺段切除术在早期肺癌治疗中的广泛应用,如何更准确、微创地完成肺段切除术已成为研究热点。本研究旨在探讨三维计算机断层扫描支气管造影和血管造影(3D-CTBA)联合灌注区域识别技术在单孔胸腔镜复杂肺段切除术中的应用。

方法

回顾性分析2021年1月至2022年1月首都医科大学宣武医院胸外科连续112例行单孔胸腔镜复杂肺段切除术患者的临床资料。采用三维重建联合灌注区域识别技术进行手术,并对临床资料进行分析。

结果

平均手术时间为(141.1±35.4)分钟;段间平面显示初始时间为(12.5±1.7)秒;段间平面维持时间为(114.3±10.9)秒;段间平面清晰显示率为100%;出血量为[10(10,20)]毫升;术后总引流量为(380.5±139.7)毫升;术后拔管时间为(3.9±1.2)天;术后住院时间为(5.2±1.6)天。术后发生并发症8例。

结论

3D-CTBA联合灌注区域识别技术在单孔胸腔镜复杂肺段切除术中识别段间边界具有快速、准确、安全的优点,可为精准切除肿瘤、缩短手术时间及减少手术并发症提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5dc/9987075/17292f124a91/img_1.jpg

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