| Objective: To explore the application and clinical significance of three-dimensional reconstruction and virtual surgical planning in anatomical segmentectomy assisted by full thoracoscopy,in a hope to formulate an individualized surgical plan and improve the accuracy and safety of surgery.Methods: All the clinical data of 101 patients in the same treatment group in the Department of Thoracic Surgery of Taizhou People Hospital from December 2016 to August 2020 were retrospectively collected.All these patients were diagnosed as GGO(Ground-Glass Opacity)≤2cm by CT before operation and underwent full thoracoscopy-assisted anatomical segmentectomy.There are 101 cases in the whole group,of which 43 are males,accounting for 42.57%,and 58 are females,accounting for 57.43%.The age range is 31-83 years old,with an average of 58.11±11.01 years old.32 cases were ≥ 65 years old,accounting for 31.68%,69 cases were younger than 65 years old,accounting for 68.32%.These patients were enrolled and divided into two groups in strict accordance with the standards of anatomical segmentectomy under thoracoscopy: control group(n=51 cases),reconstruction group(n=50 cases),both groups of patients underwent routine preoperative examination,of which reconstruction group Use Mimics 21.0 software to perform three-dimensional reconstruction through high resolution computer tomography(HRCT)images before surgery,and import the three-dimensional reconstructed images into 3-matic 13.0 software to perform virtual surgery planning,and to develop individualized surgery plan,and then implement accurate full thoracoscopic-assisted anatomical segmentectomy.The control group received routine preoperative preparations and developed surgical plans through high-resolution CT images,followed by surgical treatment.The basic information and perioperative data of the two groups of patients were collected,and SPSS 25.0 statistical software was used for statistics and analysis.For comparison of measurement data between the two groups,independent sample t-tests were used to meet normal distribution,and non-parametric tests that did not meet normal distribution were all expressed as((?)±S).The enumeration data adopts the chi-square test,expressed as[example,(%)].All test results have P<0.05 as the difference,and all are statistically significant.Results: In this study,the clinical data of 101 patients undergoing thoracoscopic anatomical segmentectomy were obtained,including 50 cases in the reconstruction group and 51 cases in the control group.The operations of the two groups of patients were successfully completed,and no patients were converted to thoracotomy during operation.The number of closure devices used in the reconstruction group was5.92±1.56,and that in the control group was 6.41±1.25.The operation time of the reconstruction group was 106.54±23.96 min,and that of the control group was120.49±28.76 min.The intraoperative blood loss in the reconstruction group was55.00±21.31 m L,and that in the control group was 76.47±45.95 m L.The number of lymph nodes dissected during the operation in the reconstruction group was 5.89±3.43,while that in the control group was 4.36±3.11.The postoperative hospital stay in the reconstruction group was 5.90±2.54 days,and that in the control group was 8.35±3.00 days.The postoperative drainage volume in the reconstruction group was699.10±540.92 m L,and that in the control group was 831.86±501.00 m L.The chest tube removal time was 5.06±2.37 days in the reconstruction group and 6.59±2.57 days in the control group.The results showed that there were statistically significant differences in operation time,intraoperative blood loss,intraoperative lymph node dissection,postoperative hospital stay,postoperative drainage volume and chest tube removal time between the two groups of data(P<0.05).There was no statistically significant difference between the two groups of data in the number of intraoperative closure devices and the total postoperative complications(P>0.05).Three-dimensional reconstruction was performed before the operation in the reconstruction group,and 4patients were found to have pulmonary arteriovenous variation.The individualized surgical plan was developed through the three-dimensional reconstruction before the operation,the pulmonary arteriovenous variation was confirmed during the operation,and the operation was successfully completed.In the control group,3 patients were found to have pulmonary arteriovenous anatomical variation.Conclusion: Three-dimensional reconstruction and virtual surgical planning can help the surgeon perform preoperative assessment,implement individualized surgical plans,enhance patient perioperative efficacy,and improve the accuracy and safety of surgery in anatomic segmentectomy assisted by full thoracoscopy. |
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