Application of 3D reconstruction and Hookwire to localize pulmonary nodules in thoracoscopic pulmonary segmentectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Qingwen ^1,2 , YIN Zhimin ² , WANG Xiaolin ² , SUN Chao ² ,  LU Shichun ² ,  SHU Yusheng ²

1. Department of Thoracic Surgery, Xiangya No.2 Hospital of Central South University, Changsha, 410000, P.R.China;
2. Department of Thoracic Surgery, Northern Jiangsu People’s Hospital, Yangzhou, 225001, Jiangsu, P.R.China;

Corresponding?author：

LU Shichun, Email: yzchest@163.com; SHU Yusheng, Email: Shuyusheng65@163.com

Keywords：

3D reconstruction; Hookwire; thoracoscopic pulmonary segmentectomy; surgery; treatment

DOI：

10.7507/1007-4848.201909011

Video：

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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 .

Citation： LIU Qingwen, YIN Zhimin, WANG Xiaolin, SUN Chao, LU Shichun, SHU Yusheng. Application of 3D reconstruction and Hookwire to localize pulmonary nodules in thoracoscopic pulmonary segmentectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(7): 802-806. doi: 10.7507/1007-4848.201909011 Copy

1.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2.	Rafiemanesh H, Mehtarpour M, Khani F, et al. Epidemiology, incidence and mortality of lung cancer and their relationship with the development index in the world. J Thorac Dis, 2016, 8(6): 1094-1102.
3.	Wang Q, Jiang W, Wang L, et al. Treatment principle and surgical technique of pulmonary ground glass nodules. Zhonghua Zhong Liu Za Zhi, 2019, 41(1): 6-9.
4.	Davini F, Ricciardi S, Zirafa CC, et al. Treatment of pulmonary nodule: from VATS to RATS. J Vis Surg, 2018, 4: 36.
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6.	Charloux A, Quoix E. Lung segmentectomy: does it offer a real functional benefit over lobectomy? Eur Respir Rev, 2017, 26(146): pii: 170079.
7.	Seguin-Givelet A, Lutz J, Brian E, et al. Surgical treatment of early stage non-small cell lung cancer by thoracoscopic segmental resection. Rev Mal Respir, 2018, 35(5): 521-530.
8.	姜格寧, 陳昶, 朱余明, 等. 上海市肺科醫院磨玻璃結節早期肺腺癌的診療共識 (第一版). 中國肺癌雜志, 2018, 21(3): 147-159.
9.	陳曉峰, 談宇龍. 胸腔鏡下肺段切除術治療非小細胞肺癌的研究現狀與進展. 中國肺癌雜志, 2018, 21(4): 296-299.
10.	Zhao ZR, Situ DR, Lau RWH, et al. Comparison of segmentectomy and lobectomy in stage ⅠA adenocarcinomas. J Thorac Oncol, 2017, 12(5): 890-896.
11.	Nomori H, Mori T, Ikeda K, et al. Segmentectomy for selected cT1N0M0 non-small cell lung cancer: a prospective study at a single institute. J Thorac Cardiovasc Surg, 2012, 144(1): 87-93.
12.	吳衛兵, 唐立鈞, 朱全, 等. 3D-CTA 重建肺血管、支氣管在胸腔鏡復雜肺段切除中應用. 中華胸心血管外科雜志, 2015, 31(11): 649-652.
13.	黃郴, 林圣美, 徐馴宇. 三維肺支氣管血管重建模擬手術在胸腔鏡肺段切除治療早期肺癌中的應用. 臨床外科雜志, 2018, 26(3): 181-183.
14.	Kurenov SN, Ionita C, Sammons D, et al. Three-dimensional printing to facilitate anatomic study, device development, simulation, and planning in thoracic surgery. J Thorac Cardiovasc Surg, 2015, 149(4): 973-979.
15.	沈誠, 李鵬飛, 李玨, 等. 胸腔鏡手術下肺小結節常見定位方法研究進展. 中國肺癌雜志, 2018, 21(8): 628-634.
16.	陸艷艷, 陳宏偉, 鮑健, 等. CT 引導下 Hookwire 定位孤立性肺結節的應用價值及并發癥的影響觀察. 臨床肺科雜志, 2018, 23(3): 425-428.
17.	Chen-Yoshikawa TF, Date H. Update on three-dimensional image reconstruction for preoperative simulation in thoracic surgery. J Thorac Dis, 2016, 8(Suppl 3): S295-S301.
18.	黃小燕, 鄭屹峰, 潘鋒, 等. 單一肺結節與兩枚以上肺結節胸腔鏡切除術前 CT 引導下 hook-wire 定位的應用價值. 腫瘤學雜志, 2017, 23(10): 914-917.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Rafiemanesh H, Mehtarpour M, Khani F, et al. Epidemiology, incidence and mortality of lung cancer and their relationship with the development index in the world. J Thorac Dis, 2016, 8(6): 1094-1102.
3. Wang Q, Jiang W, Wang L, et al. Treatment principle and surgical technique of pulmonary ground glass nodules. Zhonghua Zhong Liu Za Zhi, 2019, 41(1): 6-9.
4. Davini F, Ricciardi S, Zirafa CC, et al. Treatment of pulmonary nodule: from VATS to RATS. J Vis Surg, 2018, 4: 36.
5. 林凌, 趙珩. 意向性胸腔鏡下解剖性肺段切除在早期肺癌中的應用. 臨床外科雜志, 2017, 25(7): 495-497.
6. Charloux A, Quoix E. Lung segmentectomy: does it offer a real functional benefit over lobectomy? Eur Respir Rev, 2017, 26(146): pii: 170079.
7. Seguin-Givelet A, Lutz J, Brian E, et al. Surgical treatment of early stage non-small cell lung cancer by thoracoscopic segmental resection. Rev Mal Respir, 2018, 35(5): 521-530.
8. 姜格寧, 陳昶, 朱余明, 等. 上海市肺科醫院磨玻璃結節早期肺腺癌的診療共識 (第一版). 中國肺癌雜志, 2018, 21(3): 147-159.
9. 陳曉峰, 談宇龍. 胸腔鏡下肺段切除術治療非小細胞肺癌的研究現狀與進展. 中國肺癌雜志, 2018, 21(4): 296-299.
10. Zhao ZR, Situ DR, Lau RWH, et al. Comparison of segmentectomy and lobectomy in stage ⅠA adenocarcinomas. J Thorac Oncol, 2017, 12(5): 890-896.
11. Nomori H, Mori T, Ikeda K, et al. Segmentectomy for selected cT1N0M0 non-small cell lung cancer: a prospective study at a single institute. J Thorac Cardiovasc Surg, 2012, 144(1): 87-93.
12. 吳衛兵, 唐立鈞, 朱全, 等. 3D-CTA 重建肺血管、支氣管在胸腔鏡復雜肺段切除中應用. 中華胸心血管外科雜志, 2015, 31(11): 649-652.
13. 黃郴, 林圣美, 徐馴宇. 三維肺支氣管血管重建模擬手術在胸腔鏡肺段切除治療早期肺癌中的應用. 臨床外科雜志, 2018, 26(3): 181-183.
14. Kurenov SN, Ionita C, Sammons D, et al. Three-dimensional printing to facilitate anatomic study, device development, simulation, and planning in thoracic surgery. J Thorac Cardiovasc Surg, 2015, 149(4): 973-979.
15. 沈誠, 李鵬飛, 李玨, 等. 胸腔鏡手術下肺小結節常見定位方法研究進展. 中國肺癌雜志, 2018, 21(8): 628-634.
16. 陸艷艷, 陳宏偉, 鮑健, 等. CT 引導下 Hookwire 定位孤立性肺結節的應用價值及并發癥的影響觀察. 臨床肺科雜志, 2018, 23(3): 425-428.
17. Chen-Yoshikawa TF, Date H. Update on three-dimensional image reconstruction for preoperative simulation in thoracic surgery. J Thorac Dis, 2016, 8(Suppl 3): S295-S301.
18. 黃小燕, 鄭屹峰, 潘鋒, 等. 單一肺結節與兩枚以上肺結節胸腔鏡切除術前 CT 引導下 hook-wire 定位的應用價值. 腫瘤學雜志, 2017, 23(10): 914-917.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of 3D reconstruction and Hookwire to localize pulmonary nodules in thoracoscopic pulmonary segmentectomy

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