Exploratory Study On The Effect Of 3D Reconstruction And Location Of Pulmonary Nodules

Objective:With the popularization of CT technology and the widespread use in early lung cancer screening,the detection rates of ground-glass opacity?GGO?and solitary pulmonary nodules?SPN?have gradually increased.GGO means that the density of high-resolution CT images shows a slight increase in density and a focal cloud-like density shadow,but the bronchial and blood vessel textures within it can still be displayed.Because it is not significantly different from normal lung tissue in density.During surgery it is difficult to detect the position by sight or touch using the nodules buried deep in the lung parenchyma.General surgical methods,such as hook-line technique,CT-guided helix,microcoil positioning,and CT-guided Meilan positioning,work well during the resection,but inevitably cause substantial damage,which may lead to pneumothorax or hemothorax.complication.However,3D reconstruction is a method that does not damage the lung tissue,which may be a safer and effective option for thoracoscopic pneumonectomy for those patients with SPN or GGO.The purpose of this study was to investigate the positioning effect of 3D reconstruction in pulmonary nodule resection and its impact on the results of perioperative period.Test Method:From January 2019 to June 2019,this study included 30patients who underwent continuous VATS pneumonectomy,of which 18were wedge resections and 12 were segmentectomy.All patients underwent 3D-CT,and the wedge resection was performed by comparing the position of the pulmonary nodules found on the reconstructed image with the actual position of the pulmonary nodules during the operation.Or compared with the three-dimensional image of the actual pulmonary vascular branch pattern observed through the reconstructed vascular pattern or the lens before surgery for pulmonary segment surgery.The first endpoint of this trial is the localization success rate.If the nodule is within the resected tissue after wedge resection,and it is the RO resection margin,the localization is determined to be s₇uccessful.Or successful lung segment surgery is also determined as successful positioning.Various surgical results,the remaining endpoints include pathological resection margins.The occurrence of postoperative complications is defined in this study as Grade 2 or higher surgical results under the Clavien-Dindo classification system,and surgical time.Test results:All patients successfully completed the operation,and 18patients with wedge resection and 12patients with pulmonary segment surgery were successfully positioned.The accuracy of the resection was100%.The pathological margin of malignant nodules was 2.1±2.3 cm.The chest tube indwelling time was?4.24±2.02?days in all patients,and the bleeding volume was?15.63±9.36?ml.Preoperative 3D reconstruction was completely consistent with intraoperative 3D reconstruction.Reconstruction revealed anatomical variation in 4 patients.bacterial pneumonia occurred in 1 patient.There were no cases of transition to open and 30 days postoperatively.Conclusion:Preoperative three-dimensional reconstruction can locate small nodules on three-dimensional images,and compare intraoperative actual conditions with intraoperative localization of pulmonary nodules.It is a highly accurate and non-invasive localization method.It also helps to determine a safe surgical margin,and is also an effective method to improve the surgeon's understanding of anatomical structure and identify variant anatomy,which helps to improve the safety of the operation and simplify the surgical process.