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. 张晓菊, 白莉, 金发光, 等. 肺结节诊治中国专家共识(2018 年版). 中华结核和呼吸杂志, 2018, 41(10): 763-771.
2. 支修益, 石远凯, 于金明, 等. 中国原发性肺癌诊疗规范(2015 年版). 中华肿瘤杂志, 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. 顾春东, 刘宝东, 王群, 等. 肺小结节术前辅助定位技术专家共识(2019 版). 中国胸心血管外科临床杂志, 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. 王铁功, 金相兰, 詹茜, 等. CT 引导下 Hook wire 术前定位在 15 mm 及以下肺结节的应用及预后评估. 中华介入放射学电子杂志, 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. 张楼乾, 蒋峰, 李明, 等. 无创三维重建在肺部亚厘米结节定位中应用. 南京医科大学学报(自然科学版), 2019, 39(10): 1491-1493.
12. 张彤, 李云婧, 冯长江, 等. 经纬法在胸腔镜肺小结节手术定位中的应用. 解放军医学杂志, 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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