Thoracic Surgery Unit, Department of Translation Medicine, Università della Campania "LuigiVanvitelli", Naples, Italy.
Genomics and Experimental Oncology Unit, IOM Ricerca, Viagrande, Italy.
Thorac Cancer. 2023 Dec;14(34):3389-3396. doi: 10.1111/1759-7714.15131. Epub 2023 Oct 20.
The localization of lung nodules is challenging during thoracoscopy. In this study, we evaluated the use of three-dimensional (3D) lung reconstruction for use in the operating room to guide the identification of lung nodules during thoracoscopy.
This was a single-center retrospective study. All consecutive patients undergoing thoracoscopic resection of lung nodules were included in the study. Patients were retrospectively divided into two groups based upon whether the thoracoscopic resection was performed with the assistance (3D group) or not (standard group) of 3D lung reconstruction. The operative time (minutes) to detect lung nodules was statistically compared between the two study groups in relation to the characteristics of lung nodules as size, localization, and distance from the visceral pleura.
Our study population consisted of 170 patients: 85 in the 3D group and 85 in the standard group. No intergroup difference differences were found regarding the characteristics and histological diagnosis of lesions. The standard group compared to the 3D group was associated with a significantly longer operative time for the detection of lesions <10 mm (13.87 ± 2.59 vs. 5.52 ± 1.01, p < 0.001), lesions between 10 and 20 mm (5.05 ± 0.84 vs. 3.89 ± 0.92; p = 0.03), lesions localized in complex segments (7.49 ± 4.25 vs. 5.11 ± 0.97; p < 0.001), and deep lesions (9.58 ± 4.82 vs. 5.4 ± 1.01, p < 0.001).
Our 3D lung reconstruction model for use in the operating room may be an additional tool for thoracic surgeons to guide the detection of small and deep nodules during thoracoscopy. It is a noninvasive and cost saving procedure and may be widely used.
在胸腔镜手术中，肺结节的定位具有挑战性。在这项研究中，我们评估了三维（3D）肺重建在手术室中的使用，以指导胸腔镜手术中肺结节的识别。
这是一项单中心回顾性研究。所有连续接受胸腔镜下肺结节切除术的患者均纳入本研究。根据是否在 3D 肺重建的辅助下（3D 组）或不辅助（标准组）进行胸腔镜下切除术，将患者回顾性地分为两组。统计比较两组患者的手术时间（分钟）与结节的特征（大小、定位和距脏层胸膜的距离）之间的关系，以检测肺结节。
我们的研究人群包括 170 例患者：3D 组 85 例，标准组 85 例。两组患者的病变特征和组织学诊断无差异。与标准组相比，3D 组检测直径＜10mm 的病变时手术时间显著缩短（13.87±2.59 比 5.52±1.01，p＜0.001），直径 10-20mm 的病变（5.05±0.84 比 3.89±0.92；p=0.03），位于复杂节段的病变（7.49±4.25 比 5.11±0.97；p＜0.001），以及深部病变（9.58±4.82 比 5.4±1.01，p＜0.001）。
我们的手术室 3D 肺重建模型可能是胸外科医生在胸腔镜手术中指导检测小结节和深部结节的附加工具。它是一种非侵入性和节省成本的程序，可能会得到广泛应用。
