Application And Clinical Significance Of 3D-CTBA In Thoracoscopic Segmentectomy

Objective:To study the application and clinical significance of three-dimensional computed tomography-bronchography and angiography(3D-CTBA)in thoracic surgery and pulmonary segmentectomy.Methods:All clinical data of 90 patients who underwent thoracoscopic anatomic pulmonary segmentectomy in the same treatment group in the department of thoracic surgery,the third affiliated hospital of soochow university from May 2018 to October 2019 were retrospectively collected.The patients were included strictly according to the pulmonary segmentectomy criteria and randomly divided into two groups:the control group(n=45 cases)and the 3D group(n=45 cases).Both groups underwent routine preoperative examination and perfected high-resolution spiral CT examination,and Mimics software was used to perform 3D-CTBA in the 3D group to formulate the corresponding surgical plan and realize the precise anatomical surgical process.The control group completed the surgical plan by observing enhanced CT pictures before surgery.The two groups of operations were completed under thoracoscopy.The t test and Chi-square Test were used to compare the intraoperative and postoperative indexes of the two groups.Results:A total of 90 patients with thoracoscopic anatomical segmentectomy were collected in this study.45 patients in the 3D group and 45 patients in the control group.The operative hemorrhage in the 3D group was 134.80±11.88 ml,and the control group was 144.40 ± 8.94ml.The average operative duration of the 3D group was 113.70±6.34min,and the control group was 141.40±6.54min.The number of closure devices used in the 3D group was 5.18±0.27,and the control group was 5.80 ± 0.19.The duration of postoperative chest tube drainage in the 3D group was 3.60±0.24 days,compared with 4.64±0.20 days in the control group.The chest tube drainage in the 3D group was 541.70±45.73ml,and the control group was 746.50±45.58ml.The postoperative hospital stay in the 3D group was 6.22±0.32 days,and the control group was 7.09±0.26 days.The observation period in the 3D group was 1.73±0.09 days after operation,and the control group was 1.93±0.09 days.The results showed that there were statistically significant differences in surgical time,duration of postoperative chest tube drainage,postoperative drainage and postoperative hospital stay between the two groups(P<0.05).There were no significant differences between the two groups in terms of intraoperative blood loss,number of closure devices,observation time in the monitoring room,and total postoperative complications(P>0.05).In the 3D group,anatomical variations were found in the pulmonary arteries and veins of 3 patients,and in the control group,anatomical variations were found in the arteries and veins of 2 patients during surgery.Conclusion:3D-CTBA can help clinical workers to evaluate patients with lung cancer before surgery,and at the same time detect pulmonary artery and vein variations before surgery,so as to design surgical plans in advance and accurately operate procedures.