Application value of three-dimensional reconstruction in minimally invasive pulmonary surgery

ObjectiveTo explore the clinical value of the preoperative planning and intraoperative real-time navigation using the three-dimensional-reconstruction of bronchi, pulmonary vessels and tumors in thoracoscopic pneumonectomy.

MethodsThe clinical data of 25 non-small cell lung cancer patients treated with thoracoscopic radical lobectomy and 25 cases treated with segmental resection of pulmonary nodules were retrospectively analyzed.All patients were detected using chest thin-slice CT scan before operation, and the bronchus, pulmonary artery and pulmonary vein were reconstructed with DeepInsight software, and the pulmonary nodules, tumors or enlarged lymph nodes were also reconstructed.The accurate preoperative planning was carried out through the preoperative three-dimensional-reconstruction, especially the variation of pulmonary bronchus and blood vessels.The accurate operation were implemented using the real-time navigation of three-dimensional-reconstruction of tumors, enlarged lymph nodes and pulmonary vessels.The intraoperative conversion to thoracotomy, operation time, intraoperative bleeding and postoperative hospital stay, drainage tube removal time, total drainage volume and perioperative complications were recorded.

ResultsThe anatomical structure, variation of bronchus and pulmonary vessels were clearly reconstructed in all patients, and the relationship between the central tumor, enlarged lymph nodes and vessels were satisfactory.The locatory of pulmonary nodules in the pulmonary segments was clearly identified, and the preoperative planning was accurately carried out.The intraoperative real-time navigation was carried out in all patients, and the precise surgery was carried out according to the preoperative plan.The operation was successfully completed, and no conversion to thoracotomy or intraoperative accidental bleeding were found.The operative time was(147.60±37.77)min, the intraoperative blood loss was(33.82±22.17)mL, the postoperative hospital stay was(7.02±1.78)d, the drainage tube removal time was(4.68±1.60)d, and the postoperative total drainage volume was (221.00±135.03)mL.There were not serious complications and death in perioperative period.

ConclusionsThe application of chest thin-slice CT data in preoperative three-dimensional-reconstruction and intraoperative navigation can accurately, effectively and safely guide the thoracoscopic lobectomy and pulmonary segmentectomy.