The Study On Preoperative Planning Of Thoracic Surgery Assisted By Three-dimensional Technique

ObjectiveIn this study,three-dimensional reconstruction technique and three-dimensional printing were applied in the surgical treatment of early non-small cell lung cancer(NSCLC)with diameter≤2.0cm.The purpose is to evaluate the application value of three-dimensional reconstruction technique and three-dimensional printing in the preoperative planning for surgical treatment of early non-small cell lung cancer(NSCLC),and to introduce advanced three-dimensional technique to provide a new solution for the surgical treatment of lung occupying diseases,and to lay the foundation for the individualized precise segmentectomy surgical treatment of patients with early non-small cell lung cancer(NSCLC).MethodAbout 40 patients with early non-small cell lung cancer(NSCLC)with diameter≤2.0cm who underwent anatomical segmentectomy in our hospital from December 2019 to May 2020 were included in the study.The subjects were randomly divided into two groups: Group A(control group)and Group B(experimental group).Group A was traditional two-dimensional CT image evaluation group(Group 2D),and Group B was three-dimensional reconstruction +three-dimensional printing group(Group 3D).In Group A,conventional two-dimensional CT images were used for preoperative evaluation and surgical planning,and thoracoscopic(VATS)segmentectomy was performed.In Group B,three-dimensional visualization software Mimics was used for preoperative three-dimensional reconstruction + three-dimensional printing model,and three-dimensional reconstruction image and three-dimensional printing model were used for preoperative evaluation,operation planning,intraoperative navigation,location relationship with peripheral vessels and vascular variation were determined,and then thoracoscopic(VATS)segmentectomy was performed.The surgeons evaluated the effectiveness of preoperative three-dimensional reconstruction image and three-dimensional printing model,and recorded the operation time,intraoperative blood loss and postoperative hospital stay,and finally compared them between the two groups.ResultStatistical Methods: SPSS 23.0 software was used for t-test analysis.The operation time of Group B(experimental group)was(123.9 ± 13.00)min,which was less than that of Group A(control group)(135.0 ± 13.50)min(P = 0.0117),P < 0.05 showed that the difference was statistically significant.The intraoperative blood loss(P = 0.5006)and postoperative hospital stay(P = 0.2630)of Group A(control group)and Group B(experimental group)were higher than 0.05,indicating that the difference was not statistically significant.The coincidence rate between the actual pulmonary vein and the pulmonary vein printed by three-dimensional printing model was 100%,and no abnormal vessels were found.ConclusionCompared with conventional thoracoscopic(VATS)segmentectomy,three-dimensional reconstruction and three-dimensional printing can accurately locate the location of pulmonary nodules and clarify the course of pulmonary vessels and bronchus.The three-dimensional printing model is almost completely consistent with the actual situation,which saves the time of finding and identifying the segmental vessels and bronchus,and can significantly shorten the operation time.It shows the application value of three-dimensional technology in thoracoscopic(VATS)segmentectomy,and provides a new diagnosis and treatment idea for the complex thoracic surgery.