Primary clinical application and initial results of 3D-CTBA-guided uni-portal video-assisted thoracoscopic precision pulmonary sub-segmentectomy
Objective To assess the safety and feasibility of three-dimensional computed tomo-graphy bronchography and angiography(3 D-CTBA)-guided uni-portal video-assisted thoraco-scopic sub-segmentectomy in the treatment of pulmonary small nodules.Methods Data of 30 patients who received uni-portal video-assisted thoracoscopic sub-segmentectomy in Harbin Medical University Cancer Hospital from October 2020 to September 2022 were retrospectively analyzed,including the perioperative clinical characteristics and short term prognosis.3D-CT-BA was performed for every patient before surgery.Results All the 30 patients were success-fully performed by use of uni-portal video-assisted thoracoscopic sub-segmentectomy without conversion to thoracotomy.One patient was converted to lobectomy due to insufficient safe mar-gin,one patient lost 500 mL of blood intraoperatively due to lymph node calcification;No peri-operative mortality occurred.The surgical margin width was(27.8±8.0)mm;The mean oper-ative time was(203.8±57.5)min.The hemorrhage was 50 mL(30-500 mL)o Postoperative complications;Prolonged air leak＞3 d in 2 cases,pulmonary infection in 1 case,arrhythmia in 2 cases,and atelectasis in 1 case.Postoperative pathological examinations showed adenocar-cinoma in situ(AIS)in 1 patient,microinvasive adenocarcinoma in 10 patients,invasive non-mucinous adenocarcinoma in 17 patients,and benign pulmonary disease in 2 patients.The mean followed up was(19.4±7.1)months,all the 30 patients survived without tumor,no one showed metastasis or recurrence.Conclusion 3D-CTBA-guided uni-portal video-assisted tho-racoscopic sub-segmentectomy is a safe and feasible technique with satisfied oncologic results,which can be used in the treatment of pulmonary small nodules.
sub-segmentpulmonary sub-segmentectomyuni-portal video-assisted thoracos-copythree-dimensional reconstructionpulmonary noduleearly-stage lung cancer
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