Clinical Research Of HRCT Anatomical Mark In Precise Resection Of Lung Segment

Objective: Taking the left and right upper lungs as examples,to explore and discuss the clinical application value of HRCT anatomical markers in precise resection of lung segment.Methods: The HRCT imaging data of 112 patients with small lung nodules who were admitted to the Department of Thoracic Surgery of the First Affiliated Hospital of Bengbu Medical College and performed precision segment resection from January 2019 to January 2021 were collected.Before the operation,the left and right upper lung structures of the included patients were medically reconstructed three-dimensionally with the help of Mimics21.0 software,and the obtained double upper lung structure mutations were recorded.Combined with the clinical data of 39 cases of left upper lung and 36 cases of right upper lung anatomical segmentectomy(including: dominant lung segment,complex lung segment and combined subsegment,etc.)carried out by our department,and real-time anatomical feedback of the target lung segment during the operation.Finally,physicians at all levels in the organization department used HRCT anatomical markers to identify the pulmonary segment structure of 75 patients with HRCT data.Record,sort and analyze the data obtained above,compare the differences of the three identification methods in guiding accurate lung segment resection in terms of the accuracy and time of target lung segment anatomy recognition,and then evaluate the HRCT anatomical mark in the accurate resection of the left and right upper lung segments Application value.Results:1.1.75 patients had 38 dominant lung segments,accounting for 50.7% of the total number of bilateral upper lung segments.All the isolated specimens were examined by rapid intraoperative and postoperative paraffin pathology,and were diagnosed as benign lesions(8 cases),precancerous lesions(20 cases)and adenocarcinoma in situ(47 cases).The average intraoperative bleeding was 49.5±12.5ml,and the average operation time for each lung segment was 126.3±7.6min.2.Through the collection,comparison and analysis of the data of 75 patients,it is found that compared with the actual anatomy of the target lung segment during the operation,the HRCT anatomical identification and the medical three-dimensional reconstruction software have no statistics on the accuracy of identifying the anatomical structure of the lung target segment Academic difference(P>0.05).There was a significant statistical difference in the time it took for the two to identify the same target lung segment(P<0.01).Conclusion:1.There are many variations between the structures of the upper lungs,which must be identified by imaging data before and during the operation to prevent errors in surgical anatomy and processing.2.HRCT anatomical marks can be used to guide the resection of the left and right upper lung anatomical lung segments(the left upper lung mark: 1.Tongue bronchus opening→ 1cm below it;2.Tongue bronchus opening about 1cm above the left pulmonary artery trunk →The level of the odd venous arch.The upper right lung mark: tracheal carina→the odd venous arch→the level of the aortic arch),its recognition accuracy is not weaker than the preoperative 3D reconstruction;and the recognition efficiency is higher than the preoperative 3D reconstruction.