Comparative Study Of Three-dimensional Reconstruction Technique And Hook-wire Puncture In The Localization Of Small Pulmonary Nodules During Video-assisted Thoracoscopic Surgery

ObjectiveTo explore and compare the clinical application value of three-dimensional reconstruction technology and CT-guided Hook-wire puncture in the localization of small pulmonary nodules in video-assisted thoracoscopic surgery.Methods1.A total of 147 patients with single peripheral nodules of the lungs diagnosed and treated by thoracic surgery in our hospital from March2018 to May 2019 were collected,Among them,67 cases were localized by Hook-wire under the guidance of CT,and 80 cases were localized by three-dimensional reconstruction technology before operation.after localization,the wedge pneumonectomy was performed in both groups to clear the pathology,and whether to further lobectomy was decided according to the rapid pathological results during the operation.2.The medical records and clinical data of 147 patients with single peripheral pulmonary nodules were collected to analyze the general situation of the two groups,preoperative puncture complications,localization success rate,success rate of the wedge pneumonectomy,operation time of the wedge pneumonectomy,postoperative thoracic drainage,postoperative VAS score and so on.The clinical application value of Hook-wire puncture location and three-dimensionalreconstruction technology location was expounded by comparing and analyzing the differences between the two groups.Results1.There was no significant difference in sex,age,location of pulmonary nodules,benign or malignant nodules,pathological classification,nodule density,distance between nodule center and pleura,nodule size and other general data between the two groups(p> 0.05).2.After Hook-wire puncture and localization,pain occurred in 38 cases,bleeding in 3 cases,pain with pneumothorax in 3 cases,pain with bleeding in 5 cases,no pleural reaction,and the incidence of complications was 82.09%.There is no complications occurring in The three-dimensional group localization method,which mainly depends on preoperative imaging examination and three-dimensional reconstruction technology,combined with intraoperative anatomical landmark localization,belonging to non-invasive localization.3.Comparison of intraoperative statistical indicators the success rate of localization,the success rate of wedge resection and the operation time of wedge resection in Hook-wire puncture group were higher than those in three-dimensional reconstruction group,but there was no significant difference between the two groups(p>0.05).4.Comparison of postoperative statistical indexes,the postoperative thoracic drainage volume,the incidence of postoperative complications and VAS pain score in the three-dimensional reconstruction group were lower than those in the Hook-wire puncture group,but there was no significant difference between the two groups(p> 0.05).Conclusion1.Three-dimensional reconstruction technology and Hook-wire puncture are safe,reliable and practical methods for locating smallpulmonary nodules before video-assisted thoracoscopic surgery.2.Three-dimensional reconstruction is a non-invasive localization method,which can avoid the complications such as pneumothorax,bleeding,pain,pleural reaction and even pulmonary embolism caused by traditional invasive localization.3.The three-dimensional reconstruction image can help the operator to draw up the surgical path in advance,predict the variant blood vessels,determine the scope of resection,and improve the success rate of operation,which can be further popularized.