Application of 3D reconstruction and Hookwire to localize pulmonary nodules in thoracoscopic pulmonary segmentectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Qingwen ^1,2 , YIN Zhimin ² , WANG Xiaolin ² , SUN Chao ² ,  LU Shichun ² ,  SHU Yusheng ²

1. Department of Thoracic Surgery, Xiangya No.2 Hospital of Central South University, Changsha, 410000, P.R.China;
2. Department of Thoracic Surgery, Northern Jiangsu People’s Hospital, Yangzhou, 225001, Jiangsu, P.R.China;

Corresponding author：

LU Shichun, Email: yzchest@163.com; SHU Yusheng, Email: Shuyusheng65@163.com

Keywords：

3D reconstruction; Hookwire; thoracoscopic pulmonary segmentectomy; surgery; treatment

DOI：

10.7507/1007-4848.201909011

Video：

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Objective To investigate the clinical value of 3D CT combined with CT-guided Hookwire for localizing small pulmonary nodules in thoracoscopic pulmonary segmentectomy.Methods From December 2017 to February 2019, 39 patients received thoracoscopic pulmonary segmentectomy in our hospital, including 14 males and 25 females with a mean age of 51.33±11.17 years. Before operation, we used Mimics Medical 20.0 to re-establish the anatomy of lung and locate the small pulmonary nodules with Hookwire guided by CT. Based on the position of Hookwire needle, 3D CT images and simulated surgical methods, thoracoscopic pulmonary segmentectomy was performed accurately.Results The surgery was successfully completed in 39 patients without a transfer to open procedure. The mean operation time, mean intraoperative blood loss, mean postoperative hospital stay, mean thoracic tube drainage time were 148.97±28.56 min, 27.95±17.57 mL, 6.95±1.68 d, 4.21±1.95 d, respectively. Postoperative complications occurred in 5 patients (12.82%), including atrial fibrillation in 1, pulmonary infection in 1, chylothorax in 1, intrathoracic hemorrhage in 1 and pneumothorax in 1. All actual surgical margins were larger than 3.0 cm.Conclusion The application of preoperative 3D CT combined with CT-guided Hookwire to localize small pulmonary nodules is helpful for accurate anatomical segmental resection of the lung, making the operation safe .

Citation： LIU Qingwen, YIN Zhimin, WANG Xiaolin, SUN Chao, LU Shichun, SHU Yusheng. Application of 3D reconstruction and Hookwire to localize pulmonary nodules in thoracoscopic pulmonary segmentectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(7): 802-806. doi: 10.7507/1007-4848.201909011 Copy

1.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2.	Rafiemanesh H, Mehtarpour M, Khani F, et al. Epidemiology, incidence and mortality of lung cancer and their relationship with the development index in the world. J Thorac Dis, 2016, 8(6): 1094-1102.
3.	Wang Q, Jiang W, Wang L, et al. Treatment principle and surgical technique of pulmonary ground glass nodules. Zhonghua Zhong Liu Za Zhi, 2019, 41(1): 6-9.
4.	Davini F, Ricciardi S, Zirafa CC, et al. Treatment of pulmonary nodule: from VATS to RATS. J Vis Surg, 2018, 4: 36.
5.	林凌, 赵珩. 意向性胸腔镜下解剖性肺段切除在早期肺癌中的应用. 临床外科杂志, 2017, 25(7): 495-497.
6.	Charloux A, Quoix E. Lung segmentectomy: does it offer a real functional benefit over lobectomy? Eur Respir Rev, 2017, 26(146): pii: 170079.
7.	Seguin-Givelet A, Lutz J, Brian E, et al. Surgical treatment of early stage non-small cell lung cancer by thoracoscopic segmental resection. Rev Mal Respir, 2018, 35(5): 521-530.
8.	姜格宁, 陈昶, 朱余明, 等. 上海市肺科医院磨玻璃结节早期肺腺癌的诊疗共识 (第一版). 中国肺癌杂志, 2018, 21(3): 147-159.
9.	陈晓峰, 谈宇龙. 胸腔镜下肺段切除术治疗非小细胞肺癌的研究现状与进展. 中国肺癌杂志, 2018, 21(4): 296-299.
10.	Zhao ZR, Situ DR, Lau RWH, et al. Comparison of segmentectomy and lobectomy in stage ⅠA adenocarcinomas. J Thorac Oncol, 2017, 12(5): 890-896.
11.	Nomori H, Mori T, Ikeda K, et al. Segmentectomy for selected cT1N0M0 non-small cell lung cancer: a prospective study at a single institute. J Thorac Cardiovasc Surg, 2012, 144(1): 87-93.
12.	吴卫兵, 唐立钧, 朱全, 等. 3D-CTA 重建肺血管、支气管在胸腔镜复杂肺段切除中应用. 中华胸心血管外科杂志, 2015, 31(11): 649-652.
13.	黄郴, 林圣美, 徐驯宇. 三维肺支气管血管重建模拟手术在胸腔镜肺段切除治疗早期肺癌中的应用. 临床外科杂志, 2018, 26(3): 181-183.
14.	Kurenov SN, Ionita C, Sammons D, et al. Three-dimensional printing to facilitate anatomic study, device development, simulation, and planning in thoracic surgery. J Thorac Cardiovasc Surg, 2015, 149(4): 973-979.
15.	沈诚, 李鹏飞, 李珏, 等. 胸腔镜手术下肺小结节常见定位方法研究进展. 中国肺癌杂志, 2018, 21(8): 628-634.
16.	陆艳艳, 陈宏伟, 鲍健, 等. CT 引导下 Hookwire 定位孤立性肺结节的应用价值及并发症的影响观察. 临床肺科杂志, 2018, 23(3): 425-428.
17.	Chen-Yoshikawa TF, Date H. Update on three-dimensional image reconstruction for preoperative simulation in thoracic surgery. J Thorac Dis, 2016, 8(Suppl 3): S295-S301.
18.	黄小燕, 郑屹峰, 潘锋, 等. 单一肺结节与两枚以上肺结节胸腔镜切除术前 CT 引导下 hook-wire 定位的应用价值. 肿瘤学杂志, 2017, 23(10): 914-917.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Rafiemanesh H, Mehtarpour M, Khani F, et al. Epidemiology, incidence and mortality of lung cancer and their relationship with the development index in the world. J Thorac Dis, 2016, 8(6): 1094-1102.
3. Wang Q, Jiang W, Wang L, et al. Treatment principle and surgical technique of pulmonary ground glass nodules. Zhonghua Zhong Liu Za Zhi, 2019, 41(1): 6-9.
4. Davini F, Ricciardi S, Zirafa CC, et al. Treatment of pulmonary nodule: from VATS to RATS. J Vis Surg, 2018, 4: 36.
5. 林凌, 赵珩. 意向性胸腔镜下解剖性肺段切除在早期肺癌中的应用. 临床外科杂志, 2017, 25(7): 495-497.
6. Charloux A, Quoix E. Lung segmentectomy: does it offer a real functional benefit over lobectomy? Eur Respir Rev, 2017, 26(146): pii: 170079.
7. Seguin-Givelet A, Lutz J, Brian E, et al. Surgical treatment of early stage non-small cell lung cancer by thoracoscopic segmental resection. Rev Mal Respir, 2018, 35(5): 521-530.
8. 姜格宁, 陈昶, 朱余明, 等. 上海市肺科医院磨玻璃结节早期肺腺癌的诊疗共识 (第一版). 中国肺癌杂志, 2018, 21(3): 147-159.
9. 陈晓峰, 谈宇龙. 胸腔镜下肺段切除术治疗非小细胞肺癌的研究现状与进展. 中国肺癌杂志, 2018, 21(4): 296-299.
10. Zhao ZR, Situ DR, Lau RWH, et al. Comparison of segmentectomy and lobectomy in stage ⅠA adenocarcinomas. J Thorac Oncol, 2017, 12(5): 890-896.
11. Nomori H, Mori T, Ikeda K, et al. Segmentectomy for selected cT1N0M0 non-small cell lung cancer: a prospective study at a single institute. J Thorac Cardiovasc Surg, 2012, 144(1): 87-93.
12. 吴卫兵, 唐立钧, 朱全, 等. 3D-CTA 重建肺血管、支气管在胸腔镜复杂肺段切除中应用. 中华胸心血管外科杂志, 2015, 31(11): 649-652.
13. 黄郴, 林圣美, 徐驯宇. 三维肺支气管血管重建模拟手术在胸腔镜肺段切除治疗早期肺癌中的应用. 临床外科杂志, 2018, 26(3): 181-183.
14. Kurenov SN, Ionita C, Sammons D, et al. Three-dimensional printing to facilitate anatomic study, device development, simulation, and planning in thoracic surgery. J Thorac Cardiovasc Surg, 2015, 149(4): 973-979.
15. 沈诚, 李鹏飞, 李珏, 等. 胸腔镜手术下肺小结节常见定位方法研究进展. 中国肺癌杂志, 2018, 21(8): 628-634.
16. 陆艳艳, 陈宏伟, 鲍健, 等. CT 引导下 Hookwire 定位孤立性肺结节的应用价值及并发症的影响观察. 临床肺科杂志, 2018, 23(3): 425-428.
17. Chen-Yoshikawa TF, Date H. Update on three-dimensional image reconstruction for preoperative simulation in thoracic surgery. J Thorac Dis, 2016, 8(Suppl 3): S295-S301.
18. 黄小燕, 郑屹峰, 潘锋, 等. 单一肺结节与两枚以上肺结节胸腔镜切除术前 CT 引导下 hook-wire 定位的应用价值. 肿瘤学杂志, 2017, 23(10): 914-917.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of 3D reconstruction and Hookwire to localize pulmonary nodules in thoracoscopic pulmonary segmentectomy

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