三维重建技术在单孔胸腔镜肺手术中的应用效果

Application effect of 3D reconstruction technique in uniportal video-assisted thoracoscopic lobectomy

目的:通过观察单孔胸腔镜肺手术中三维重建组和非重建组手术相关指标方面的差异,评估术前三维重建技术对单孔胸腔镜肺手术相关指标的影响。方法:回顾性研究2020年05月至2021年12月期间连续164例接受单孔胸腔镜肺叶切除术的患者的临床资料,根据其术前是否实施CT三维重建分为重建组(75例)和非重建组(89例)。比较两组术中情况和术后结果,评估指标包括手术时间、出血量、中转多孔或开胸、术后疼痛、术后并发症等结果方面的差异。结果:两组患者性别、年龄、病变肺叶位置及术前肿瘤分期等基本情况具有可比性(P>0.05)。重建组手术时间、术中出血量、中转多孔或开胸比率低于非重建组(P<0.05);两组患者术中淋巴结清扫数目、术后疼痛、术后引流量、术后并发症等差异无统计学意义(P>0.05)。结论:术前个体化的胸廓、支气管和肺血管三维重建有助于安全有效地实施单孔胸腔镜手术,减少术中出血并降低中转开胸的比率。

Objective:To evaluate the effect of preoperative 3D reconstruction technique on the relevant indexes of uniportal video-assisted thoracoscopic lobectomy by observing the differences between the 3D reconstruction group and the non-reconstruction group.Methods:A retrospective study was conducted on 164 consecutive patients who underwent single-port thoracoscopic lobectomy from May 2020 to December 2021.The patients were divided into reconstruction group(75 cases)and non-reconstruction group(89 cases)according to whether CT three-dimensional reconstruction was performed before surgery.Intraoperative and postoperative outcomes were compared between the two groups,with evaluation indicators including differences in operative time,blood loss,transit porosity or thoracotomy,postoperative pain,and postoperative complications.Results:Basic information such as gender,age,location of diseased lung lobe and preoperative tumor stage were comparable between the two groups(P>0.05).The operative time,intraoperative blood loss,transporosity or thoracotomy ratio in the reconstruction group were lower than those in the non-reconstruction group(P<0.05).There was no statistical significance in the number of intraoperative lymph node dissection,postoperative pain,postoperative drainage volume and postoperative complications between the two groups(P>0.05).Conclusion:Preoperative individualized 3D reconstruction of thoracic,bronchial and pulmonary vessels is helpful to safely and effectively perform uniportal video-assisted thoracoscopic lobectomy,reduce intraoperative bleeding and reduce the rate of conversion to thoracotomy.