Application of 3D reconstruction and Hookwire to localize pulmonary nodules in thoracoscopic pulmonary segmentectomy / 中国胸心血管外科临床杂志

ABSTRACT

@#Objective    To investigate the clinical value of 3D CT combined with CT-guided Hookwire for localizing small pulmonary nodules in thoracoscopic pulmonary segmentectomy. Methods    From December 2017 to February 2019, 39 patients received thoracoscopic pulmonary segmentectomy in our hospital, including 14 males and 25 females with a mean age of 51.33±11.17 years. Before operation, we used Mimics Medical 20.0 to re-establish the anatomy of lung and locate the small pulmonary nodules with Hookwire guided by CT. Based on the position of Hookwire needle, 3D CT images and simulated surgical methods, thoracoscopic pulmonary segmentectomy was performed accurately. Results    The surgery was successfully completed in 39 patients without a transfer to open procedure. The mean operation time, mean intraoperative blood loss, mean postoperative hospital stay, mean thoracic tube drainage time were 148.97±28.56 min, 27.95±17.57 mL, 6.95±1.68 d, 4.21±1.95 d, respectively. Postoperative complications occurred in 5 patients (12.82%), including atrial fibrillation in 1, pulmonary infection in 1, chylothorax in 1, intrathoracic hemorrhage in 1 and pneumothorax in 1. All actual surgical margins were larger than 3.0 cm. Conclusion    The application of preoperative 3D CT combined with CT-guided Hookwire to localize small pulmonary nodules is helpful for accurate anatomical segmental resection of the lung, making the operation safe .