ObjectiveTo analyze the application effects of artificial intelligence (AI) software and Mimics software in preoperative three-dimensional (3D) reconstruction for thoracoscopic anatomical lung segment resection. MethodsA retrospective analysis was conducted on patients who underwent thoracoscopic lung segment resection surgery at the Second People's Hospital of Huai'an from October 2019 to March 2024. Patients who underwent AI software 3D reconstruction were included in the AI group, those who underwent Mimics software 3D reconstruction were included in the Mimics group, and those who did not undergo 3D reconstruction were included in the control group. Perioperative related indicators of each group were compared. ResultsA total of 168 patients were included, including 73 males and 95 females, aged 25-81 (61.61±10.55) years. There were 79 patients in the AI group, 53 patients in the Mimics group, and 36 patients in the control group. There were no statistically significant differences in gender, age, smoking history, nodule size, number of lymph node dissection groups, postoperative pathological results, and postoperative complications among the three groups (P>0.05). There were statistically significant differences in operation time (P<0.001), extubation time (P<0.001), drainage volume (P<0.001), bleeding volume (P<0.001), and postoperative hospital stay (P=0.001) among the three groups. There were no statistically significant differences in operation time, extubation time, bleeding volume, and postoperative hospital stay between the AI group and the Mimics group (P>0.05). There was no statistically significant difference in drainage volume between the AI group and the control group (P>0.05). ConclusionFor patients requiring thoracoscopic anatomical lung segment resection, preoperative 3D reconstruction and preoperative planning based on 3D images can shorten the operation time, postoperative extubation and hospital stay, and reduce intraoperative bleeding and postoperative drainage volume compared with reading CT images only. The use of AI software for 3D reconstruction is not inferior to Mimics manual 3D reconstruction in terms of surgical guidance and postoperative recovery, which can reduce the workload of clinicians and is worth promoting.