Three‐dimensional (3D)‐ computed tomography bronchography and angiography combined with 3D‐video‐assisted thoracic surgery (VATS) versus conventional 2D‐VATS anatomic pulmonary segmentectomy for the treatment of non‐small cell lung cancer

Abstract

BackgroundCompared to the pulmonary lobe, the anatomical structure of the pulmonary segment is relatively complex and prone to variation, thus the risk and difficulty of segmentectomy is increased. We compared three‐dimensional computed tomography bronchography and angiography (3D‐CTBA) combined with 3D video‐assisted thoracic surgery (3D‐VATS) to perform segmentectomy to conventional two‐dimensional (2D)‐VATS for the treatment of non‐small cell lung cancer (NSCLC).MethodsWe retrospectively reviewed the data of randomly selected patients who underwent 3D‐CTBA combined with 3D‐VATS (3D‐CTBA‐VATS) or 2D‐VATS at the Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University Hospital, from January 2014 to May 2017.ResultsThe operative duration of 3D group was significantly shorter than the 2D group (P < 0.05). There was no significant difference in the number of dissected lymph nodes between the two groups (P > 0.05). The extent of intraoperative bleeding and postoperative drainage in the 3D group was significantly lower than in the 2D group (P < 0.05). Chest tube duration in the 3D group was shorter than in the 2D group (P < 0.05). Incidences of pulmonary infection, atelectasis, and arrhythmia were not statistically different between the two groups (P > 0.05). However, hemoptysis and pulmonary air leakage (>3d) occurred significantly less frequently in the 3D than in the 2D group (P < 0.05).Conclusion3D‐CTBA‐VATS is a more accurate and smooth technique and leads to reduced intraoperative and postoperative complications.

Nanoparticle-based CT visualization of pulmonary vasculature for minimally-invasive thoracic surgery planning

“…Injection of contrast to improve resection planning is not a novel concept. Studies have used multidimensional CT imaging along with injected iodinated contrast medium to render the pulmonary arteriovenous structures in 3D prior to the surgical procedure [28,55–58]. Preoperative CT-based planning offers similar operative time, mortality, morbidity, and complication rates with the advantage of identifying difficult surgical cases early [55].…”

Utility of preoperative three-dimensional CT bronchography and angiography in uniportal video-assisted thoracoscopic anatomical lobectomy: a retrospective propensity score-matched analysis

“…With the development of thin-section multidetector CT (MDCT) and application software technology, threedimensional (3D) reconstruction imaging has been widely adopted by surgeons. Compared with traditional two-dimensional (2D) CT imaging, 3D reconstruction imaging can provide physicians with a more detailed view of the relative position of the pulmonary anatomical structure (13,14). To date, various 3D reconstruction software applications have been successfully applied by researchers to improve the precision of segmentectomy, subsegmentectomy, and even sub-subsegmentectomy (15)(16)(17)(18).…”

Preoperative virtual simulation for synchronous multiple primary lung cancers using three-dimensional computed tomography lung reconstruction: a case report

“…However, controversies related to the method of resection still exist. To obtain a prognosis similar to that of solitary primary lung cancers (SPLCs), even those of a similar histologic subtype, and preserve postoperative pulmonary function, different surgical procedures based on the experience of the surgeons; the patient’s age and cardiopulmonary function; and the size, quantity, and distribution of nodules have been individually adopted [ 2 , 3 ]. Three-dimensional computed tomography lung reconstruction (3D-CTLR) can accurately determine the relative positions of these nodules in the lobes.…”