Application of three‐dimensional reconstruction of left upper lung lobes in anatomical segmental resection

Fan, Kun; Feng, Jinteng; Li, Yixing; Liu, Bohao; Tao, Runyi; Wang, Zhiyu; Zhao, Heng; Zhang, Yanpeng; Wang, Jiansheng; Zhang, Guangjian

doi:10.1111/1759-7714.14379

Cited by 9 publications

(6 citation statements)

References 13 publications

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“…The left upper lobe is the largest lung lobe in the human body, and it also has the most anatomical variation ( 6 ). Reports of variations similar to those in the mediastinal lingular segmental artery are available ( 7 ), but a few systematic reports on the variations in the left upper lobe blood vessels and bronchus also exist. The anatomy of the upper lobe of the left lung is complex, and it is currently customary to divide the upper lobe of the left lung into the proper segment [including apical posterior segment (LS1 + 2) + anterior segment (LS3)] and the lingular segment [including upper lingular segment (LS4) + lower lingular segment (LS5)].…”

Section: Discussionmentioning

confidence: 99%

Anatomical variation analysis of left upper pulmonary blood vessels and bronchi based on three-dimensional reconstruction of chest CT

et al. 2022

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BackgroundWith its growing popularity and potential outcome, preoperative three-dimensional reconstruction of chest computed tomography (CT) has been widely used in video-assisted thoracic surgery (VATS) segmentectomy for treating non-small cell lung cancer (NSCLC). This study aimed to summarize the experience of anatomical variation analysis of left upper pulmonary blood vessels and bronchi based on the three-dimensional reconstruction of chest CT.Materials and methodsA total of 103 patients with early-stage NSCLC were chosen to undergo VATS segmentectomy based on preoperative three-dimensional reconstruction of chest CT in our institute from September 2019 to July 2022. Data such as clinical characteristics and variations in blood vessels and bronchi were reviewed in this study.ResultsThe branches of the left lingular pulmonary artery may mutate into the LS1 + 2 + 3. A1 + 2 has four subtypes. The distribution of variation is relatively balanced, and the most common variation is type I (35/103, 33.9%). Most lingular arteries originate from the oblique cleft side of the lingular bronchus (79/103,76.7%). Most V(1 + 2)c* are small developments (70/103, 68.0%). The venous return of the proper segment mainly depends on V(1 + 2)b + c. The variation in the left upper lobe bronchus is complex. The most common variant is the bifurcation type (type A to G, 92/103, 89.3%) and bifurcation type A (62/103, 60.2%). The posterior apical segment artery of the left upper lobe is not accompanied by its bronchus.ConclusionsThe variation types of blood vessels and bronchus in the upper lobe of the left lung are complex. Preoperative CT-based three-dimensional reconstruction of pulmonary arteries, veins, and bronchi is of great significance. It can help understand the variations, accurately locate lesions before the surgery, and effectively plan surgeries.

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Section: Discussionmentioning

confidence: 99%

Anatomical variation analysis of left upper pulmonary blood vessels and bronchi based on three-dimensional reconstruction of chest CT

et al. 2022

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“…Prior to surgery, a comprehensive assessment of pulmonary blood vessel orientation and variation, encompassing pulmonary veins, arteries, and each lobar bronchus, is paramount to reduce bleeding risks during surgery and to formulate effective preoperative surgical plans ( ICHINOSE et al, 2019 ). Recent clinical studies suggest that sub-segmental resection of the lung is superior to traditional segmental resection in terms of fewer complications and similar prognoses, highlighting the importance of using three-dimensional reconstruction technology to improve preoperative pulmonary vascular assessment ( FAN et al, 2022 ; SAJI et al, 2022 ). Therefore, obtaining an accurate understanding of the pulmonary artery’s orientation and variation before surgery is of significant value in reducing bleeding risks during surgery ( NIA et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…Using pulmonary CT angiography, computer DCM image data can be obtained, allowing for the convenient and straightforward reconstruction of the corresponding pulmonary artery model through inputting the data into relevant three-dimensional reconstruction software. Additionally, pulmonary artery variations can be analyzed, and the branch and course of the pulmonary artery can be observed clearly, which is far more convenient and easy than the traditional anatomical dye perfusion method ( FAN et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Analysis of pulmonary artery variation based on 3D reconstruction of CT angiography

Qin

et al. 2023

Front. Physiol.

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Objective: The aim of this study is to acquire pulmonary CT (Computed tomography) angiographic data for the purpose of creating a three-dimensional reconstruction. Additionally, we aim to analyze the features and deviations of the branches in both pulmonary lobes. This information is intended to serve as a more comprehensive and detailed reference for medical professionals when conducting preoperative evaluations and devising surgical plans.Method: Between August 2019 and December 2021, 420 patients were selected from the thoracic surgery department at the First Hospital of Jilin University, and underwent pulmonary 64 channel contrast enhanced CT examinations (Philips ICT 256). The images were acquired at a 1.5 mm slice thickness, and the DCM files that complied with DICOM (Digital Imaging and Communications in Medicine) standards were analysed for 3D (three dimensional) reconstruction using Mimics 22.0 software. The reconstructed pulmonary artery models were assessed by attending chest surgeons and radiologists with over 10 years of clinical experience. The two-dimensional image planes, as well as the coronary and sagittal planes, were utilized to evaluate the arteries. The study analyzed the characteristics and variations of the branches and courses of pulmonary arteries in each lobe of the lungs, with the exception of the subsegmental arterial system. Two chest surgeons and two radiologists with professional titles-all of whom had over a decade of clinical experience-jointly evaluated the 3D models of the pulmonary artery and similarly assessed the characteristics and variations of the branches and courses in each lobe of the lungs.Results: Significant variations were observed in the left superior pulmonary artery across the 420 subjects studied. In the left upper lobe, the blood supply of 4 arteries accounted for 50.5% (n = 212), while the blood supply of 2 arteries in the left lower lobe was the most common, accounting for 79.5% (n = 334). The greatest variation in the right pulmonary artery was observed in the branch supply of the right upper lobe mediastinal artery. In the majority of cases (77.9%), there were two arteries present, which was the most common configuration observed accounting for 64% (n = 269). In the right inferior lobe of the lung, there were typically 2–4 arteries, with 2 arteries being the most common configuration (observed in 79% of cases, n = 332).Conclusion: The three-dimensional reconstruction of pulmonary artery CT angiography enables clear observation of the branches and distribution of the pulmonary artery while also highlighting any variations. This technique holds significant clinical value for preoperative assessments regarding lesions and blood vessels.

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“…If injected too quickly, it may even cause pulmonary embolism [ 12 ]. With the development of digital medical imaging technology, 3D reconstruction techniques have been widely used in various aspects of preoperative assessment of thoracoscopic precision lung segment resection, localization of lung nodules, simulation of surgical protocols, and intraoperative guidance for identification of bronchi and pulmonary vessels [ 9 , 13 , 14 ]. In the era of medicine that emphasizes individualized treatment, preoperative 3D reconstruction images can be used to quickly and intuitively identify individual anatomical patterns through a 360-degree view and observation and judgment from multiple levels and angles, which is an important guarantee for accurate lung segment resection.…”

Section: Discussionmentioning

confidence: 99%

Comparison of three-dimensional reconstruction and CT-guided Hook-wire segmental resection for pulmonary nodules: a propensity score matching study

Hong

Sheng

et al. 2023

World J Surg Onc

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Objective To analyze and compare the clinical application value of three-dimensional reconstruction and computed tomography (CT)-guided Hook-wire localization for row lung segment resection of pulmonary nodules. Methods Retrospective analysis of the clinical data of 204 patients suffering from pulmonary nodules admitted to the Department of Thoracic Surgery of Gansu Provincial People’s Hospital from June 2016 to December 2022. According to the preoperative positioning method, the group was divided into a 3D reconstruction group (98 cases) and a Hook-wire group (106 cases), respectively. The two groups of patients were propensity score matching (PSM) to compare their perioperative outcomes. Results All patients in both groups underwent successful surgeries without perioperative deaths. After PSM, 79 patients were successfully matched in each group. Two cases of pneumothorax, three cases of hemothorax, and four cases of decoupling occurred in the Hook-wire group; no complications of pneumothorax, hemothorax, and decoupling occurred in the 3D reconstruction group. Compared to the Hook-wire group, the 3D reconstruction group has shorter operative time (P = 0.001), less intraoperative bleeding (P < 0.001), less total postoperative chest drainage (P = 0.003), shorter postoperative tube placement time (P = 0.001), shorter postoperative hospital stay (P = 0.026), and postoperative complications (P = 0.035). There was no statistically significant difference between the two groups in terms of pathological type, TNM staging, and number of lymph node dissection. Conclusion Three-dimensional reconstruction and localization of pulmonary nodules enables safe and effective individualized thoracoscopic anatomical lung segment resection with a low complication rate, which has good clinical application value.

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Application of three‐dimensional reconstruction of left upper lung lobes in anatomical segmental resection

Cited by 9 publications

References 13 publications

Anatomical variation analysis of left upper pulmonary blood vessels and bronchi based on three-dimensional reconstruction of chest CT

Anatomical variation analysis of left upper pulmonary blood vessels and bronchi based on three-dimensional reconstruction of chest CT

Analysis of pulmonary artery variation based on 3D reconstruction of CT angiography

Comparison of three-dimensional reconstruction and CT-guided Hook-wire segmental resection for pulmonary nodules: a propensity score matching study

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