Application value of three-dimensional reconstruction for localization of pulmonary nodules in thoracoscopic lung wedge resection: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Yuanguo , YAO Sheng , LIU Canhui , XU Jiyang , ZHU Chengxiang ,  DONG Guohua

Department of Thoracic and Cardiovascular Surgery, Nanjing Hospital of Traditional Chinese Medicine, Nanjing University of Traditional Chinese Medicine, Nanjing, 210001, P.R.China;

Corresponding?author：

DONG Guohua, Email: dongguohua@163.com

Keywords：

Three-dimensional reconstruction; pulmonary nodules; preoperative localization; thoracoscopic lung wedge resection

DOI：

10.7507/1007-4848.202101047

Video：

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Objective To evaluate the safety and application value of three-dimensional reconstruction for localization of pulmonary nodules in thoracoscopic lung wedge resection.Methods The clinical data of 96 patients undergoing thoracoscopic lung wedge resection in our hospital from January 2019 to August 2020 were retrospectively reviewed and analyzed, including 30 males and 66 females with an average age of 57.62±12.13 years. The patients were divided into two groups, including a three-dimensional reconstruction guided group (n=45) and a CT guided Hook-wire group (n=51). The perioperative data of the two groups were compared.Results All operations were performed successfully. There was no statistically significant difference between the two groups in the failure rate of localization (4.44% vs. 5.88%, P=0.633), operation time [15 (12, 19) min vs. 15 (13, 17) min, P=0.956], blood loss [16 (10, 20) mL vs. 15 (10, 19) mL, P=0.348], chest tube placement time [2 (2, 2) d vs. 2 (2, 2) d, P=0.841], resection margin width [2 (2, 2) cm vs. 2 (2, 2) cm, P=0.272] or TNM stage (P=0.158). The complications of CT guided Hook-wire group included pneumothorax in 2 patients, hemothorax in 2 patients and dislodgement in 4 patients. There was no complication related to puncture localization in the three-dimensional reconstruction guided group.Conclusion Based on three-dimensional reconstruction, the pulmonary nodule is accurately located. The complication rate is low, and it has good clinical application value.

Citation： LIU Yuanguo, YAO Sheng, LIU Canhui, XU Jiyang, ZHU Chengxiang, DONG Guohua. Application value of three-dimensional reconstruction for localization of pulmonary nodules in thoracoscopic lung wedge resection: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(10): 1207-1211. doi: 10.7507/1007-4848.202101047 Copy

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1. 張曉菊, 白莉, 金發光, 等. 肺結節診治中國專家共識(2018 年版). 中華結核和呼吸雜志, 2018, 41(10): 763-771.
2. 支修益, 石遠凱, 于金明, 等. 中國原發性肺癌診療規范(2015 年版). 中華腫瘤雜志, 2015, 37(1): 67-78.
3. Balderson SS, D'Amico TA. Thoracoscopic lobectomy for the management of non-small cell lung cancer. Curr Oncol Rep, 2008, 10(4): 283-286.
4. 顧春東, 劉寶東, 王群, 等. 肺小結節術前輔助定位技術專家共識(2019 版). 中國胸心血管外科臨床雜志, 2019, 26(2): 109-113.
5. Zhang H, Li Y, Yimin N, et al. CT-guided hook-wire localization of malignant pulmonary nodules for video assisted thoracoscopic surgery. J Cardiothorac Surg, 2020, 15(1): 307.
6. Yao F, Wang J, Yao J, et al. Three-dimensional image reconstruction with free open-source OsiriX software in video-assisted thoracoscopic lobectomy and segmentectomy. Int J Surg, 2017, 39: 16-22.
7. Sardari Nia P, Olsthoorn JR, Heuts S, et al. Interactive 3D reconstruction of pulmonary anatomy for preoperative planning, virtual simulation, and intraoperative guiding in video-assisted thoracoscopic lung surgery. Innovations (Phila), 2019, 14(1): 17-26.
8. Park CH, Han K, Hur J, et al. Comparative effectiveness and safety of preoperative lung localization for pulmonary nodules: A systematic review and meta-analysis. Chest, 2017, 151(2): 316-328.
9. 王鐵功, 金相蘭, 詹茜, 等. CT 引導下 Hook wire 術前定位在 15 mm 及以下肺結節的應用及預后評估. 中華介入放射學電子雜志, 2020, 8(1): 70-76.
10. Wu WB, Xu XF, Wen W, et al. Three-dimensional computed tomography bronchography and angiography in the preoperative evaluation of thoracoscopic segmentectomy and subsegmentectomy. J Thorac Dis, 2016, 8(Suppl 9): S710-S715.
11. 張樓乾, 蔣峰, 李明, 等. 無創三維重建在肺部亞厘米結節定位中應用. 南京醫科大學學報(自然科學版), 2019, 39(10): 1491-1493.
12. 張彤, 李云婧, 馮長江, 等. 經緯法在胸腔鏡肺小結節手術定位中的應用. 解放軍醫學雜志, 2019, 44(12): 1043-1046.
13. Xu Y, Gan F, Xia C, et al. Discovery of lung surface intersegmental landmarks by three dimensional reconstruction and morphological measurement. Transl Lung Cancer Res, 2019, 8(6): 1061-1072.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application value of three-dimensional reconstruction for localization of pulmonary nodules in thoracoscopic lung wedge resection: A retrospective cohort study

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