Three-dimensional Printing Technology For Localised Thoracoscopic Segmental Resection For Lung Cancer

Objective: Three-dimensional(3D)computed tomography(CT)reconstruction technology has gained attention owing to its potential in locating ground glass nodules in the lung.The 3D printing technology additionally allows the visualisation of the surrounding anatomical structure and variations.However,the clinical utility of these techniques is unknown.This study aimed to establish a lung tumour and an anatomical lung model using 3D printing and 3D chest CT reconstruction and to evaluate the clinical potential of 3D printing technology in uniportal video-assisted thoracoscopic segmentectomy.Methods: Patients with ground glass nodules and underwent uniportal video-assisted thoracoscopic segmentectomy who met the inclusion criteria were randomly divided into the following two groups: group A,lung models for pre-positioning and simulated surgery that were performed with 3D chest CT reconstruction and 3D printing;group B,patients who underwent chest CT scans with image enhancement.Finally,89 patients were included: 51 patients in the experimental group(21 men and 30 women,48-75 years old,average age 60.73 years old;17 patients had a history of smoking),38 patients in the control group(14 men and 24 women,49-77 years old,average age61.61 years old;11 smokers).There was no significant difference in general characteristics between the two groups.The surgery approach transfer rate,lobectomy conversion rate,operative time,intraoperative blood loss,and postoperative complication rate were compared between the two groups.Results: Between 3D reconstruction combined with 3D printing group and control group,there were significant differences in the approach transfer rate(0% vs.10.5%,P=0.030),operative time(2.07±0.24 hours vs.2.55±0.41 hours,P <0.001),intraoperative blood loss volume(43.25±13.63 m L vs.96.68±32.82 m L,P <0.001)and the rate of surgical method conversion to lobectomy(0% vs.10.5%,P <0.030).In contrast,there was an insignificant difference in the postoperative complication rate between between3 D reconstruction combined with 3D printing group and control group(3.9% vs.13.2%,P =0.132).Conclusions: The application of chest CT 3D reconstruction combined with 3D printing technology in segmentectomy of pulmonary ground glass nodules has certain advantages,which can reduce approach transfer rate,operative time,intraoperative blood loss,the rate of surgical method conversion to lobectomy.3D reconstruction combined with 3D printing technology is helpful to improve the accuracy and safety of thoracoscopic surgery for pulmonary ground glass nodules,which is worthy of clinical application.