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Abstract Background With the popularity of LDCT screening, increasingly more small pulmonary nodules are being found, and segmentectomy is widely performed because of its advantages in the treatment of early lung cancer. However, the feasibility of segmentectomy is controversial because of the highly intricate nature of the operation, especially in complex cases. Preoperative three-dimensional reconstruction (3DR) is an effective method to ensure a smooth operation, but its role in complex segmentectomy has not yet been verified. This study was performed to assess the value of preoperative 3DR in complex pulmonary segmentectomy by retrospective analysis of preoperative 3DR-assisted single-port video-assisted thoracoscopic complex pulmonary segmentectomy and comparison of surgery-related indicators. Methods The clinical data of patients with pulmonary nodules who underwent single-port thoracoscopic complex segmentectomy (n = 299) from August 2015 to February 2019 were retrospectively analyzed. The patients were divided into a preoperative 3DR group (n = 156) and non-3DR group (n = 143). Perioperative outcomes were compared between the two groups after comparative propensity score-matching analysis according to patient age, sex, body mass index, lung function, smoking history, major tumor components, and tumor size. Results Each group comprised 125 patients after propensity score matching, and the baseline characteristics of the patients were comparable. There were no significant differences in age, sex, body mass index, smoking history, tumor histology, or tumor size between the two groups (all P > 0.05). Additionally, the 3DR and non-3DR groups showed no significant differences in the number of lymph nodes dissected (9.4 ± 5.1 vs. 10.6 ± 7.0), postoperative drainage volume (510.5 ± 279.4 vs. 528.7 ± 379.4 mL), duration of chest tube placement (2.3 ± 1.1 vs. 2.5 ± 1.6 days), incidence of chronic air leakage (0.8% vs. 0.8%), total complications (2.4% vs. 5.6%), or 30-day postoperative mortality (0% vs. 0%). However, significant differences were found in the operative time (178.6 ± 50.5 vs. 202.1 ± 51.4 min) and intraoperative blood loss (47.6 ± 37.9 vs. 58.4 ± 36.2 mL) (P < 0.05). Conclusion This is the first study to evaluate the usefulness of preoperative 3DR in complex segmentectomy. The results showed that the use of preoperative 3DR for complex pulmonary segmentectomy is a safe and effective method that can significantly reduce the operation time and blood loss.
Chen et al. (Thu,) studied this question.