Application Of Three-Dimensional Reconstruction And Virtual Surgical Planning In Single-Port Thoracoscopic Anatomical Lung Resection

Background and purpose:Video-assisted thoracoscopic(VATS)segmentectomy is an acceptable alternative to lobectomy for the treatment of early-stage lung cancer.Uniportal video-assisted thoracic surgery(U-VATS)segmental resection is a challenging surgical operation with great technical difficulty and complications.In this study,the application value of three-dimensional reconstruction and virtual surgical planning in single-port thoracoscopic anatomical segment resection was explored,and the application of U-VATS segment resection was promoted.Methods:The clinical data of 98 patients underwent single-port thoracoscopic anatomical segmentectomy in the Department of Thoracic Surgery of the Second Affiliated Hospital of Nanchang University from October 2018 to December 2020 were collected.Among them,42 cases were male,accounting for 42.86%,and 56 cases were female,accounting for 57.14%.Age 28-72 years old,average 56.23±10.16 years old.The diameter of small lung nodules or ground glass shadows is 0.6-2.0cm,with an average of 1.23±0.28cm.There were 13 cases of benign nodules,34 cases of in situ adenocarcinoma,18 cases of minimally invasive adenocarcinoma,and 33 cases of adenocarcinoma.According to whether three-dimensional reconstruction was performed before operation,they were divided into three-dimensional reconstruction group and non-three-dimensional reconstruction group,with 52 cases in the three-dimensional reconstruction group and 46 cases in the non-three-dimensional reconstruction group.By analyzing the perioperative indicators of the two groups of patients,the application value of three-dimensional reconstruction and virtual surgical planning in single-port thoracoscopic anatomical segment resection was explored.Results:Both groups of patients successfully completed segmentectomy under single-port thoracoscopy.During the operation,there was no conversion to thoracotomy or increased surgical incisions,and no perioperative death or serious complications occurred.There was no significant difference between the three-dimensional reconstruction group and the non-three-dimensional reconstruction group in age,gender,the location and size of small lung nodules or ground glass shadows,and the number and number of intraoperatively dissected lymph nodes,and there was no statistical significance(P>0.05).In the three-dimensional reconstruction group,the operation time[(105.98±26.51)ml vs(127.34±32.87)ml p=0.001],the intraoperative blood loss[(47.85±32.76)ml vs(86.22±51.68)ml p=0.000],the surgical cut Margin distance[(2.23±0.14)cm vs(2.11±0.23)cm p=0.002],postoperative chest drainage[(427.14±183.46)ml vs(562.33±203.87)ml p=0.001],postoperative extubation time[(3.56±0.81)d vs(4.76±2.19)d p=0,000],postoperative hospital stay[(4.60±1.43)d vs(5.42±2.28)d p=0.033]is better than the non-three-dimensional reconstruction group,there are differences between the two groups Statistical significance.At the same time,the incidence of postoperative complications in the three-dimensional reconstruction group was lower than that of the non-three-dimensional reconstruction group,and the difference between the two groups was statistically significant(P<0.05).Conclusion:Three-dimensional reconstruction and virtual surgical planning have significant perioperative effects in single-port thoracoscopic anatomical lung segment resection,which can improve the accuracy and safety of the operation,have clinical application and promotion value,and will promote single-port thoracoscopic anatomy More applications of segmental lung resection in the treatment of stage IA NSCLC.