Application Research Of The IQQA Three-dimensional Reconstruction System In Uniport Video-assisted Thoracoscopic Complicated Segmentectomy

Background: With the popularization of LDCT(Low dose computed tomography)screening,more and more pulmonary nodules have been found,and pulmonary segmentectomy is more and more widely used due to its advantages in early lung cancer resection.However,due to the complexity of the procedure,the feasibility of pulmonary segmentectomy is still controversial.Especially in complicated pulmonary segmentectomy is more controversial.Preoperative IQQA three dimensional reconstruction is one of the effective methods to ensure the smooth operation.However,its role in complex pulmonary segmentectomy has not been verified.This paper intends to evaluate the value of preoperative IQQA three-dimensional reconstruction in complicated pulmonary segmentectomy by retrospectively analyzing the relevant indexes of complicated pulmonary segmentectomy with or without IQQA three-dimensional reconstruction before surgery.Methods: We retrospectively analysis the patients with pulmonary noduls who underwent single-port thoracoscopic complicated segmentectomy between June2017 and March 2020.According to whether IQQA three-dimensional reconstruction was performed before surgery,the patients were divided into the three-dimensional reconstruction group and non-three-dimensional reconstruction group.The types of lung segmentectomy,operative time,intraoperative blood loss,number and groups of lymph node dissection,retention time of chest drainge tube,drainage volume,postoperative complications,hospitalization time and cost were compared between two group to determine the effectiveness of IQQA three-dimensional reconstruction in complex segmentectomy.Results: A total of 360 patients were included in this study,including 279 patients in three dimensional reconstruction group and 81 patients in non-three dimensional reconstruction group.In terms of surgical difficulty,the three dimensional reconstruction group included 144 patients with fairly difficulty(51.6%)and 135 patients with difficult pulmonary segmentectomy(48.4%),while the non-three dimensional reconstruction group included 69 patients with fairly difficulty(85.2%)and 12 patients with difficult pulmonary segmentectomy(14.8%).The surgical difficulty of the three dimensional reconstruction group was significantly higher than that of the non-three dimensional reconstruction group(P<0.001).The amount of intraoperative blood loss(40.57±19.03 ml vs.52.47±44.15 ml,P < 0.001),the number(7.89±5.00 vs.10.90±6.39,P < 0.001)and groups(4.24±1.68 vs.4.74±1.93,P=0.024)of lymph nodes dissection in the three dimensional reconstruction group were significantly lower than those in the non-three dimensional reconstruction group,and the differences were statistically significant.There were making no differences in the operative time,postoperative drainage volume,time of thoracic catheter indwellin,postoperative hospital stay,incidence of prolonged air leakage,incidence of total complications and 30-day postoperative mortality between the two groups(P > 0.05).Conclusion: For patients who require complex segmentectomy,preoperative IQQA three-dimensional reconstruction can achieve accurate positioning of lesions,fine planning of surgical procedures and precise anatomy of hilar structure to ensure the successful completion of complex segmentectomy,which is worthy of recommendation.