Application of computer-aided design modified 3D printing model in video-assisted thoracoscopic sublobular resection for early lung cancer: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Xinyu ^1,2 , LI Linqian ^3,4,5 , LI Haoran ^1,2 , GUO Qiang ^1,5 , YAN Hongli ^4,5 , LI Jinghua ^4,5 , CHENG Shujie ^4,5 , LI Hefei ^1,5 ,  ZHANG Ke ^1,3,4,5 , YANG Jihong ^4,5 , WU Jianguo ⁴

1. Department of Thoracic Surgery, Affiliated Hospital of Hebei University, Baoding, 071000, Hebei, P. R. China;
2. Department of Medicine, Hebei University, Baoding, 071000, Hebei, P. R. China;
3. 3D Image and 3D Printing Center, Affiliated Hospital of Hebei University, Baoding, 071000, Hebei, P. R. China;
4. Basic Research Key Laboratory of General Surgery for Digital Medicine, Baoding, 071000, Hebei, P. R. China;
5. Institute of Life Science and Green Development, Hebei University, Baoding, 071000, Hebei, P. R. China;

Corresponding?author：

ZHANG Ke, Email: 93391@qq.com

Keywords：

Computer-aided design; video-assisted thoracoscopic surgery; 3D printing; sublobectomy

DOI：

10.7507/1007-4848.202212033

Video：

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Objective To compare the effect of three-dimensional visual (3DV) model, three-dimensional printing (3DP) model and computer-aided design (CAD) modified 3DP model in video-assisted thoracoscopic surgery (VATS) sublobular resection. Methods The clinical data of patients who underwent VATS sublobular resection in the Affiliated Hospital of Hebei University from November 2021 to August 2022 were retrospectively analyzed. The patients were divided into 3 groups including a 3DV group, a 3DP group and a CAD-3DP group according to the tools used. The perioperative indexes and subjective evaluation of operators, patients and their families were compared. Results A total of 22 patients were included. There were 5 males and 17 females aged 32-77 (56.95±12.50) years. There were 9 patients in the 3DV group, 6 patients in the 3DP group, and 7 patients in the CAD-3DP group. There was no statistical difference in the operation time, intraoperative blood loss, drainage volume, hospital stay time or postoperative complications among the groups (P>0.05). Based on the subjective evaluations of 4 surgeons, the CAD-3DP group was better than the 3DV group in the preoperative planning efficiency (P=0.025), intuitiveness (P=0.045) and doctor-patient communication difficulty (P=0.034); the CAD-3DP group was also better than the 3DP group in the overall satisfaction (P=0.023), preoperative planning difficulty (P=0.046) and efficiency (P=0.014). Based on the subjective evaluations of patients and their families, the CAD-3DP group was better than the 3DP group in helping understand the vessel around the tumor (P=0.016), surgical procedure (P=0.020), procedure selection (P=0.029), and overall satisfaction (P=0.048); the CAD-3DP group was better than the 3DV group in helping understand the tumor size (P=0.038). Conclusion CAD-modified 3DP model has certain advantages in pre-planning, intraoperative navigation and doctor-patient communication in the VATS sublobectomy.

Citation： ZHANG Xinyu, LI Linqian, LI Haoran, GUO Qiang, YAN Hongli, LI Jinghua, CHENG Shujie, LI Hefei, ZHANG Ke, YANG Jihong, WU Jianguo. Application of computer-aided design modified 3D printing model in video-assisted thoracoscopic sublobular resection for early lung cancer: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(9): 1266-1273. doi: 10.7507/1007-4848.202212033 Copy

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2.	Segaran N, Saini G, Mayer JL, et al. Application of 3D printing in preoperative planning. J Clin Med, 2021, 10(5): 917.
3.	Sardari Nia P, Olsthoorn JR, Heuts S, et al. Interactive 3D reconstruction of pulmonary anatomy for preoperative planning, virtual simulation, and intraoperative guiding in video-assisted thoracoscopic lung surgery. Innovations (Phila), 2019, 14(1): 17-26.
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7.	Li C, Zheng B, Yu Q, et al. Augmented reality and 3-dimensional printing technologies for guiding complex thoracoscopic surgery. Ann Thorac Surg, 2021, 112(5): 1624-1631.
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10.	Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg, 1995, 60(3): 615-622.
11.	Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019, 158(3): 895-907.
12.	Bédat B, Abdelnour-Berchtold E, Perneger T, et al. Comparison of postoperative complications between segmentectomy and lobectomy by video-assisted thoracic surgery: A multicenter study. J Cardiothorac Surg, 2019, 14(1): 189.
13.	Cao J, Yuan P, Wang Y, et al. Survival rates after lobectomy, segmentectomy, and wedge resection for non-small cell lung cancer. Ann Thorac Surg, 2018, 105(5): 1483-1491.
14.	Tejo-Otero A, Buj-Corral I, Fenollosa-Artés F. 3D printing in medicine for preoperative surgical planning: A review. Ann Biomed Eng, 2020, 48(2): 536-555.
15.	Xiang Z, Wu B, Zhang X, et al. Preoperative three-dimensional lung simulation before thoracoscopic anatomical segmentectomy for lung cancer: A systematic review and meta-analysis. Front Surg, 2022, 9: 856293.
16.	Liu X, Zhao Y, Xuan Y, et al. Three-dimensional printing in the preoperative planning of thoracoscopic pulmonary segmentectomy. Transl Lung Cancer Res, 2019, 8(6): 929-937.
17.	王亞芳, 房婉嵐, 陳恩國. 肺結節定位的研究進展. 現代實用醫學, 2022, 34(1): 3-6.Wang YF, Fang WL, Chen EG. Research progress on pulmonary nodule localization. Mod Pract Med, 2022, 34(1): 3-6.
18.	Chen Y, Zhang J, Chen Q, et al. Three-dimensional printing technology for localised thoracoscopic segmental resection for lung cancer: A quasi-randomised clinical trial. World J Surg Oncol, 2020, 18(1): 223.
19.	Yoon SH, Park S, Kang CH, et al. Personalized 3D-printed model for informed consent for stageⅠlung cancer: A randomized pilot trial. Semin Thorac Cardiovasc Surg, 2019, 31(2): 316-318.

1. Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
2. Segaran N, Saini G, Mayer JL, et al. Application of 3D printing in preoperative planning. J Clin Med, 2021, 10(5): 917.
3. Sardari Nia P, Olsthoorn JR, Heuts S, et al. Interactive 3D reconstruction of pulmonary anatomy for preoperative planning, virtual simulation, and intraoperative guiding in video-assisted thoracoscopic lung surgery. Innovations (Phila), 2019, 14(1): 17-26.
4. Ji Y, Zhang T, Yang L, et al. The effectiveness of three-dimensional reconstruction in the localization of multiple nodules in lung specimens: A prospective cohort study. Transl Lung Cancer Res, 2021, 10(3): 1474-1483.
5. Hamada A, Oizumi H, Kato H, et al. Outcome of thoracoscopic anatomical sublobar resection under 3-dimensional computed tomography simulation. Surg Endosc, 2022, 36(4): 2312-2320.
6. Hu W, Zhang K, Han X, et al. Three-dimensional computed tomography angiography and bronchography combined with three-dimensional printing for thoracoscopic pulmonary segmentectomy in stage ⅠA non-small cell lung cancer. J Thorac Dis, 2021, 13(2): 1187-1195.
7. Li C, Zheng B, Yu Q, et al. Augmented reality and 3-dimensional printing technologies for guiding complex thoracoscopic surgery. Ann Thorac Surg, 2021, 112(5): 1624-1631.
8. Qiu B, Ji Y, He H, et al. Three-dimensional reconstruction/personalized three-dimensional printed model for thoracoscopic anatomical partial-lobectomy in stage Ⅰ lung cancer: A retrospective study. Transl Lung Cancer Res, 2020, 9(4): 1235-1246.
9. 中華醫學會, 中華醫學會腫瘤學分會, 中華醫學會雜志社. 中華醫學會肺癌臨床診療指南(2018版). 中華腫瘤雜志, 2018, 40(12): 935-964.Chinese Medical Association, Oncology Society of Chinese Medical Association, Chinese Medical Association Publishing House. Chinese Medical Association guidelines for clinical diagnosis and treatment of lung cancer (edition 2018). Chin J Oncol, 2018, 40(12): 935-964.
10. Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg, 1995, 60(3): 615-622.
11. Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019, 158(3): 895-907.
12. Bédat B, Abdelnour-Berchtold E, Perneger T, et al. Comparison of postoperative complications between segmentectomy and lobectomy by video-assisted thoracic surgery: A multicenter study. J Cardiothorac Surg, 2019, 14(1): 189.
13. Cao J, Yuan P, Wang Y, et al. Survival rates after lobectomy, segmentectomy, and wedge resection for non-small cell lung cancer. Ann Thorac Surg, 2018, 105(5): 1483-1491.
14. Tejo-Otero A, Buj-Corral I, Fenollosa-Artés F. 3D printing in medicine for preoperative surgical planning: A review. Ann Biomed Eng, 2020, 48(2): 536-555.
15. Xiang Z, Wu B, Zhang X, et al. Preoperative three-dimensional lung simulation before thoracoscopic anatomical segmentectomy for lung cancer: A systematic review and meta-analysis. Front Surg, 2022, 9: 856293.
16. Liu X, Zhao Y, Xuan Y, et al. Three-dimensional printing in the preoperative planning of thoracoscopic pulmonary segmentectomy. Transl Lung Cancer Res, 2019, 8(6): 929-937.
17. 王亞芳, 房婉嵐, 陳恩國. 肺結節定位的研究進展. 現代實用醫學, 2022, 34(1): 3-6.Wang YF, Fang WL, Chen EG. Research progress on pulmonary nodule localization. Mod Pract Med, 2022, 34(1): 3-6.
18. Chen Y, Zhang J, Chen Q, et al. Three-dimensional printing technology for localised thoracoscopic segmental resection for lung cancer: A quasi-randomised clinical trial. World J Surg Oncol, 2020, 18(1): 223.
19. Yoon SH, Park S, Kang CH, et al. Personalized 3D-printed model for informed consent for stageⅠlung cancer: A randomized pilot trial. Semin Thorac Cardiovasc Surg, 2019, 31(2): 316-318.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of computer-aided design modified 3D printing model in video-assisted thoracoscopic sublobular resection for early lung cancer: A retrospective cohort study

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