Clinical Application Of CT Three-dimensional Reconstruction Technology In The Treatment Of Pulmonary Nodules In Anatomical Segmentectomy

Objectives:To explore the clinical application value of CT three-dimensional reconstruction technology in the treatment of pulmonary nodules in anatomic segmentectomy,including the influence of perioperative indicators and preoperative operation guidance.Methods:The clinical data of 40 patients with pulmonary nodule treated by thoracoscopic dissection from September 2019 to January 2021 were analyzed retrospectively.Among them,9 men(22.5%),31 females(77.5%),36-70 years old,average 51.8±8.1 years old.The diameter of small pulmonary nodules was 0.3-1.2cm,with an average of 0.62cm.Benign 2 cases(5%),0 stage 3 cases(7.5%),IA1 stage 34 cases(85%),IA2 stage 1 case(2.5%).There were 5 cases(12.5%)of the complications before operation,which were hypertension 2 cases,a dysfunctional one,atrial arrhythmia 1 case,simultaneously combined hypertension and coronary heart disease 1 case.The patients were divided into three-dimensional reconstruction group(18 cases)and spring coil positioning group(22 cases).The results of age,sex,complication,nodule diameter and location,histopathological stage,operation time,bleeding amount during operation,number of lymph nodes cleaned during operation,postoperative complications(such as pulmonary infection,pleural effusion,postoperative leakage,etc.),time of extraction of closed drainage tube after operation,hospitalization time and total postoperative flow rate were recorded.The results of the two groups were compared to explore the value of CT 3D reconstruction in the treatment of pulmonary nodule in anatomical segmental resection.Results:The two groups of patients were successfully completed,but in the coil positioning group,one case was transferred to thoracotomy because of serious adhesion between an abnormal branch artery and lymph nodes in the proper segment of the left upper lobe,which was not found in the preoperative evaluation.There was no significant difference in age,gender,number of complications,diameter of pulmonary nodules and histopathological stage between the three-dimensional reconstruction group and the coil positioning group(P>0.05).In the operation time,intraoperative blood loss,postoperative extubation time,postoperative total drainage and postoperative complications(three-dimensional reconstruction group:2 cases of air leakage;coil positioning group:3 cases of air leakage,5 cases of pleural effusion,2 cases of pulmonary infection),the three-dimensional reconstruction group was significantly lower than the coil positioning group,the difference was statistically significant(P>0.05).However,there was no significant difference in the number of lymph node dissection groups and postoperative hospital stay(P>0.05).There was no perioperative death or 30 day postoperative death in both groups.Conclusions:1.Through CT three-dimensional reconstruction technology,the anatomical structure of pulmonary artery,vein,bronchus and pulmonary nodule can be clearly displayed before operation,which is conducive to the location of lesions,accurate judgment of surgical margin and formulation of surgical plan,and is of great significance for accurate anatomical segmentectomy.2.CT three-dimensional reconstruction technology in the treatment of pulmonary nodules in anatomical segmentectomy,while ensuring safe surgical resection,can shorten the operation time,reduce intraoperative blood loss,and improve the accuracy and safety of surgery.3.The use of CT three-dimensional reconstruction technology can reduce the extubation time,postoperative total drainage and the incidence of postoperative complications,which is conducive to the rapid recovery of patients.