Application Of 3D Reconstruction Technology In The Perioperative Period Of Robotic-Assisted Thoracoscopic Anatomical Segmentectomy

Objective.This study mainly explores the application value of 3D reconstruction technology in the perioperative period of robotic-assisted thoracoscopic segmentectomy,and intends to analyze its feasibility,safety and efficacy,in order to provide clinical evidence for clinical thoracic surgeons to operate on lung malignant tumors.Materials and methods.This study was a simultaneous controlled trial,and 60 patients who underwent pulmonary segmental resection for pulmonary nodules in the Department of Thoracic Surgery of Gansu Provincial People’s Hospital from January 2022 to December 2022 were collected according to the inclusion and exclusion criteria,and the patients were divided into reconstructed and non-reconstructed groups according to whether they underwent 3D reconstruction before surgery,and the general data(such as height,weight,age,BMI),hematological indexes,oncological indexes and surgical time,intraoperative bleeding,postoperative drainage time,postoperative drainage flow and postoperative complications and other surgical data.Data normality test and analysis were performed with SPSS 26.0,and the mean ± standard deviation was used to conform to the normal distribution;M(Q25-Q75)was used to indicate that the distribution did not conform to the normal distribution.Results.There were no statistically significant differences in the general data,preoperative hematological indices,oncological indices and preoperative pulmonary function between the two groups.The differences in operative time [(104.94±5.52)min vs(127.15±9.47)min,P<0.05],intraoperative bleeding volume [30(20～50)mL vs 50(42.5～100)m L,P<0.05] and nodule search time [8.5(7.75～10)min vs 9(8～12)min,P<0.05] were statistically significant.Postoperative drainage flow [(732.21±90.80)m L vs(990.58±113.92)m L,P>0.05],postoperative drainage time [4(3-5.25)d vs 4(3-6)d,P>0.05],postoperative hospital stay[6.5(4-8)d vs 6(5-8.25)d,P>0.05],postoperative complications in both groups The differences in incidence [20.58% vs 19.23% P>0.05] were not statistically significant.The detection rate of benign nodules by 3D reconstruction was 47.06%(16/34)and malignant nodules was52.94%(19/34),and the diagnostic accuracy,sensitivity,and specificity were 91.18%,86.67%,and 94.74%,respectively,and the positive likelihood ratio,negative likelihood ratio,and Yordon index were 16.48,0.14,and 0.814,respectively.Some patients in the reconstruction group were subjected to postoperative three-dimensional reconstruction,and the reconstruction results could observe whether the target lung segment was accurately resected,as well as the target trachea and target vessel stump in the surgical area,and whether there was missection,etc.CONCLUSIONS.The application of 3D reconstruction techniques in robot-assisted thoracoscopic anatomical segmental lung resection is safe and feasible.It can shorten the operative time,reduce intraoperative bleeding,and shorten the search time for nodules,and has a high diagnostic efficacy for nodule benignity and malignancy.However,further studies are needed to assess the prognosis of patients,and we expect to improve the preoperative planning with the results of postoperative 3D reconstruction.