Clinical application of Mimics software system to three-dimensional reconstruction to guide thoracoscopic anatomic pulmonary segmentectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Shuang , SHI Yijun , DING Guowen , SUN Yangyong , LÜ Benbo , LIU Jianchao ,  ZHU Jingfeng

Department of Cardiothoracic Surgery, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 212000, Jiangsu, P. R. China;

Corresponding author：

ZHU Jingfeng, Email: zhujingfeng0511@outlook.com

Keywords：

Mimics software; video-assisted thoracoscopy; three-dimensional reconstruction; pulmonary segmentectomy; early-stage lung cancer

DOI：

10.7507/1007-4848.202304015

Video：

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Objective To investigate the clinical effect of 3D computed tomography bronchial bronchography and angiography (3D-CTBA) and guidance of thoracoscopic anatomic pulmonary segmentectomy by Mimics software system. Methods A retrospective analysis was performed on patients who underwent thoracoscopic segmentectomy in the Department of Thoracic Surgery of Affiliated People's Hospital of Jiangsu University from June 2020 to December 2022. The patients who underwent preoperative 3D-CTBA using Materiaise's interactive medical image control system (Mimics) were selected as an observation group, and the patients who did not receive 3D-CTBA were selected as a control group. The relevant clinical indicators were compared between the two groups. Results A total of 59 patients were included, including 29 males and 30 females, aged 25-79 years. There were 37 patients in the observation group, and 22 patients in the control group. The operation time (163.0±48.7 min vs. 188.8±43.0 min, P=0.044), intraoperative blood loss [10.0 (10.0, 20.0) mL vs. 20.0 (20.0, 35.0) mL, P<0.001], and preoperative puncture localization rate (5.4% vs. 31.8%, P=0.019) in the observation group were better than those in the control group. There was no statistically significant difference in the thoracic tube placement time, thoracic fluid drainage volume, number of intraoperative closure nail bin, postoperative hospital stay, or postoperative air leakage incidence (P>0.05) between the two groups. Conclusion For patients who need to undergo anatomical pulmonary segmentectomy, using Mimics software to produce 3D-CTBA before surgery can help accurately identify pulmonary arteriovenous anatomy, reduce surgical time and intraoperative blood loss, help to determine the location of nodules and reduce invasive localization before surgery, and alleviate patients' pain, which is worthy of clinical promotion.

Citation： LI Shuang, SHI Yijun, DING Guowen, SUN Yangyong, LÜ Benbo, LIU Jianchao, ZHU Jingfeng. Clinical application of Mimics software system to three-dimensional reconstruction to guide thoracoscopic anatomic pulmonary segmentectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(1): 59-64. doi: 10.7507/1007-4848.202304015 Copy

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2.	Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
3.	Altorki NK, Wang X, Wigle D, et al. Perioperative mortality and morbidity after sublobar versus lobar resection for early-stage non-small-cell lung cancer: Post-hoc analysis of an international, randomised, phase 3 trial (CALGB/Alliance 140503). Lancet Respir Med, 2018, 6(12): 915-924.
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7.	Dziedzic R, Zurek W, Marjanski T, et al. StageⅠnon-small-cell lung cancer: Long-term results of lobectomy versus sublobar resection from the Polish National Lung Cancer Registry. Eur J Cardiothorac Surg, 2017, 52(2): 363-369.
8.	Xu H, Zhao H, Jin J, et al. An atlas of anatomical variants of subsegmental pulmonary arteries and recognition error analysis. Front Oncol, 2023, 13: 1127138.
9.	Maki R, Miyajima M, Ogura K, et al. Pulmonary vessels and bronchus anatomy of the left upper lobe. Surg Today, 2022, 52(4): 550-558.
10.	Huang HZ, Wang GZ, Xu LC, et al. CT-guided Hookwire localization before video-assisted thoracoscopic surgery for solitary ground-glass opacity dominant pulmonary nodules: Radiologic-pathologic analysis. Oncotarget, 2017, 8(64): 108118-108129.
11.	Chen D, Chen CH, Tang L, et al. Three-dimensional reconstructions in spine and screw trajectory simulation on 3D digital images: A step by step approach by using Mimics software. J Spine Surg, 2017, 3(4): 650-656.
12.	陈亮, 吴卫兵. 胸腔镜解剖性肺段切除术技术要点. 中国肺癌杂志, 2016, 19(6): 377-381.
13.	李小军, 朱潇, 杏福宝, 等. 三维重建及3D打印在微创肺外科中的应用. 中华全科医学, 2020, 18(7): 1190-1194.
14.	You YH, Zhao D, Huang QB, et al. Application of Mimics Medical 21.0 Software in thoracoscopic anatomical sublobectomy. Minerva Surg, 2022, 77(3): 221-228.
15.	刘让, 陈李李, 俞经生, 等. Mimics三维重建技术在胸腔镜解剖性肺段切除手术中的应用效果分析. 临床肺科杂志, 2022, 27(12): 1845-1849.
16.	宋明磊, 曹富民, 邢晓英, 等. 交互式医学图像控制系统软件三维重建在肺腺癌复杂肺段切除术中的应用. 中华全科医学, 2022, 20(5): 735-739.

1. Duma N, Santana-Davila R, Molina JR. Non-small cell lung cancer: Epidemiology, screening, diagnosis, and treatment. Mayo Clin Proc, 2019, 94(8): 1623-1640.
2. Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
3. Altorki NK, Wang X, Wigle D, et al. Perioperative mortality and morbidity after sublobar versus lobar resection for early-stage non-small-cell lung cancer: Post-hoc analysis of an international, randomised, phase 3 trial (CALGB/Alliance 140503). Lancet Respir Med, 2018, 6(12): 915-924.
4. 酒涛, 李彦周, 武新. 胫骨平台骨折Mimics三维重建及临床应用效果分析. 深圳中西医结合杂志, 2020, 30(1): 178-179.
5. Nooreldeen R, Bach H. Current and future development in lung cancer diagnosis. Int J Mol Sci, 2021, 22(16): 8661.
6. Zhang Y, Fu F, Chen H. Management of ground-glass opacities in the lung cancer spectrum. Ann Thorac Surg, 2020, 110(6): 1796-1804.
7. Dziedzic R, Zurek W, Marjanski T, et al. StageⅠnon-small-cell lung cancer: Long-term results of lobectomy versus sublobar resection from the Polish National Lung Cancer Registry. Eur J Cardiothorac Surg, 2017, 52(2): 363-369.
8. Xu H, Zhao H, Jin J, et al. An atlas of anatomical variants of subsegmental pulmonary arteries and recognition error analysis. Front Oncol, 2023, 13: 1127138.
9. Maki R, Miyajima M, Ogura K, et al. Pulmonary vessels and bronchus anatomy of the left upper lobe. Surg Today, 2022, 52(4): 550-558.
10. Huang HZ, Wang GZ, Xu LC, et al. CT-guided Hookwire localization before video-assisted thoracoscopic surgery for solitary ground-glass opacity dominant pulmonary nodules: Radiologic-pathologic analysis. Oncotarget, 2017, 8(64): 108118-108129.
11. Chen D, Chen CH, Tang L, et al. Three-dimensional reconstructions in spine and screw trajectory simulation on 3D digital images: A step by step approach by using Mimics software. J Spine Surg, 2017, 3(4): 650-656.
12. 陈亮, 吴卫兵. 胸腔镜解剖性肺段切除术技术要点. 中国肺癌杂志, 2016, 19(6): 377-381.
13. 李小军, 朱潇, 杏福宝, 等. 三维重建及3D打印在微创肺外科中的应用. 中华全科医学, 2020, 18(7): 1190-1194.
14. You YH, Zhao D, Huang QB, et al. Application of Mimics Medical 21.0 Software in thoracoscopic anatomical sublobectomy. Minerva Surg, 2022, 77(3): 221-228.
15. 刘让, 陈李李, 俞经生, 等. Mimics三维重建技术在胸腔镜解剖性肺段切除手术中的应用效果分析. 临床肺科杂志, 2022, 27(12): 1845-1849.
16. 宋明磊, 曹富民, 邢晓英, 等. 交互式医学图像控制系统软件三维重建在肺腺癌复杂肺段切除术中的应用. 中华全科医学, 2022, 20(5): 735-739.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical application of Mimics software system to three-dimensional reconstruction to guide thoracoscopic anatomic pulmonary segmentectomy

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