首页|术前三维重建应用于跨段肺结节切除的单中心回顾性队列研究

术前三维重建应用于跨段肺结节切除的单中心回顾性队列研究

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目的 探究术前三维重建对于肺癌患者跨段肺结节手术切除的应用价值.方法 回顾性分析中日友好医院胸外科2023年1-11月术前应用三维重建技术患者的临床资料.术前用三维重建技术做手术规划,根据结节位置、大小、距胸膜距离指导胸腔镜下手术切除方式,行楔形、肺段或肺叶切除术.结果 共纳入115例患者,其中男45例、女70例,年龄25~84(58.29±11.36)岁,均顺利完成手术.结节直径切缘跨段55例(47.8%),其中结节跨段25例(21.7%).CT上外1/3结节中有21例行楔形切除,且楔形切除相比较其他手术方式手术时间更短、花费更少(P<0.001)、术中出血量更少(P=0.019),差异有统计学意义.CT上中内1/3结节跨段或切缘跨段者行单纯肺段切除6例,肺段联合亚段切除8例,联合肺段切除7例,肺叶切除5例,楔形切除3例.结论 跨段肺结节比例较高.对于CT上外1/3结节来说,与肺段切除联合毗邻肺组织切除相比,楔形切除同样可以保证足够的外科切缘,CT上中内1/3结节则大多需要通过肺段切除联合毗邻肺组织切除的手术方式来保证手术切缘.
Application value of preoperative three-dimensional reconstruction in the resection of lung nodules:A retrospective cohort study in a single center
Objective To explore the guiding significance of preoperative 3D reconstruction for pulmonary nodule location and thoracoscopic surgical method selection in lung cancer patients.Methods The clinical data of the patients with preoperative 3D reconstruction in our China-Japan Friendship Hospital between January and November 2023 were retrospectively analyzed.Preoperative surgical planning was performed using 3D reconstruction.Different surgical procedure,including wedge resection,segmentectomy,lobectomy,or combined surgical procedure were performed based on tumor location,size and distance from the pleura.Results A total of 115 patients were included with 45 males and 70 females,at an average age of 25-84(58.29±11.36)years and successfully completed the operation.Fifty-five(47.8%)patients'nodule diameter was tangent cross-section,among whom twenty-five(21.7%)patients of nodules crossed sections.There were 21 patients of wedge resection in the outer 1/3 nodules of CT,which had shorter operation time and less cost(P<0.001)and less intraoperative bleeding(P=0.019).For the crossing sections or edge crossing sections nodules of the middle and inner of CT,6 patients were of simple pulmonary segmentectomy,8 patients of combined with sub-segmentectomy,7 patients of combined segmentectomy,5 patients of lobectomy,and 3 patients of wedge resection.Conclusion The proportion of cross-segment pulmonary nodules is relatively high.For the outer 1/3 nodules of CT,compared with pulmonary segmental resection combined with adjacent lung tissue resection,wedge resection can also ensure sufficient surgical margin,and the middle and inner 1/3 nodules of CT need to be combined with adjacent pulmonary tissue resection to ensure the surgical edge.

Three-dimensional reconstructionthoracoscopic surgerylung cancersegmentectomy

祁菲、冯宏响、朱伟杰、石玉慧、刘德若、梁朝阳、张真榕

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中日友好医院(中日友好临床医学研究所)/北京协和医学院/中国医学科学院(北京 100029)

中日友好医院胸外科(北京 100029)

三维重建 胸腔镜手术 肺癌 肺段切除

中日医院菁英计划研究项目高水平医院临床业务费专项国家重点研发计划

ZRJY2021-TD042022-NHLHCRF-YS-042022YFC2407302

2024

中国胸心血管外科临床杂志
四川大学华西医院

中国胸心血管外科临床杂志

CSTPCD北大核心
影响因子:0.846
ISSN:1007-4848
年,卷(期):2024.31(10)
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