Three‐dimensional navigation‐guided thoracoscopic combined subsegmentectomy for intersegmental pulmonary nodules

Wu, Weibing; Xia, Yang; Pan, Xinliang; Wang, Jun; He, Zhicheng; Xu, Jianping; Wen, Wei; Xu, Xinfeng; Zhu, Quan; Chen, Liang

doi:10.1111/1759-7714.12897

Cited by 29 publications

(36 citation statements)

References 18 publications

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“…For nodules located at the margin of a segment or between adjacent segments, extensive segmentectomy is similar to an extended wedge resection: segmentectomy plus wedge resection ( 27 ). But, not all pulmonary nodules which meet this criterion are fit for combined subsegmentectomy.…”

Section: Resultsmentioning

confidence: 99%

“…But, not all pulmonary nodules which meet this criterion are fit for combined subsegmentectomy. For instance, when the pulmonary nodules are located centrally and the distance between the bronchial origin of the subsegment in question and the nodules is no longer than the size of the nodules, combined subsegmentectomy does not identify a reliable surgical margin, while lobectomy is necessary ( 27 ). The part of the structure of the lung anatomic segmentectomy was shown in Figure 2 .…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, a study by Mingming Ren shows that VATS segmentectomy was performed safely and is a method with favorable 1-year survival. It may be the ideal surgical procedure for patients with solitary pulmonary nodules in early-stage lung cancer, especially for those with limited cardiopulmonary reserve or significant comorbidities ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

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Identifying Lung Cancer Patients Suitable for Segmentectomy: A Brief Review

Wang

Zhang³

et al. 2021

Front. Surg.

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Background: In 1995, a clinical randomized controlled study (RCT) conducted by the Lung Cancer Study Group (LCSG) pointed out that the lobectomy was the gold standard for treating early lung cancer. However, with the development of technology, the results of several retrospective studies have shown that the efficacy of pulmonary segmentectomy is equivalent to that of lobectomy. Currently, it is still controversial whether segmental resection or lobectomy should be performed for early lung cancer. Thus, we aim to summarize the indications of segmentectomy.Methods: To conduct the review, previous researches involving indications of segmentectomy were collected from the literature using Pubmed. These articles were published and accepted in English in the medical literature from 2013 to 2020. We have focused on segmentectomy and its indications.Results: A total of 176 articles were retrieved from the Pubmed database, of which 31 articles included indications for segmentectomy. We summarized the relevant content, and the potential and prospect of segmentectomy for the treatment of lung cancer were emphasized.Conclusions: These findings have a number of important implications for future practice. Pulmonary segmentectomy is a very vital surgical procedure for select patients with lung cancer, which provides a novel approach for the treatment of lung cancer and the survival of lung cancer patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Identifying Lung Cancer Patients Suitable for Segmentectomy: A Brief Review

Wang

Zhang³

et al. 2021

Front. Surg.

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“…3D imaging technology has developed rapidly in recent years. With the increasing popularity of anatomical segmentectomy, various 3D reconstruction software designed to assist with the conversion of 2D-CT images to 3D digital images have been developed (16,17,24). Studies have found 3D reconstruction to be useful for identifying intersegmental veins as boundary lines of pulmonary segments in the determination of surgical margins before segmentectomy (17,25).…”

Section: Discussionmentioning

confidence: 99%

Utility of preoperative three-dimensional CT bronchography and angiography in uniportal video-assisted thoracoscopic anatomical lobectomy: a retrospective propensity score-matched analysis

Zhu¹,

Yao²,

Xu³

et al. 2021

Ann Transl Med

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Background: Personalized three-dimensional (3D) reconstruction can help surgeons to overcome technical challenges and variations of pulmonary anatomic structures in the performance of uniportal video-assisted thoracoscopic surgery (UVATS), thus improving the safety and efficacy of the procedure. This study aims to evaluate the utility of preoperative 3D-CT bronchography and angiography (3D-CTBA) with Exoview software in the assessment of anatomical variations of pulmonary vessels, and to analyze short-term surgical outcomes in patients undergoing UVATS lobectomy. Methods:We retrospectively analyzed the data of 198 consecutive patients who underwent curative UVATS lobectomy between November 2019 and September 2020. The patients were divided into an "Exoview" group (n=53) and a "non-Exoview" group (n=145). We performed 1:1 propensity score matching and compared intraoperative and postoperative outcomes between the two groups. A subgroup analysis of 74 patients who underwent single-direction uniportal lobectomy was also conducted. Aberrant pulmonary vessel patterns related to the surgery were also examined. Results:The operative time in the Exoview group was significantly shorter than that in the non-Exoview group, both before (145.7±33.9 vs. 159.5±41.6 minutes, P=0.032) and after (145.7±33.9 vs. 164.2±41.8 minutes, P=0.014) propensity score matching. The number of mediastinal lymph nodes dissected was higher in the Exoview group than in the non-Exoview group (8.19±6.89 vs. 5.78±3.3, P=0.024) after propensity score matching. Intraoperative blood loss showed a statistical difference between the Exoview and non-Exoview groups (60.4±45.4 vs. 100.8±83.9, P=0.009). Four types of arterial variations and 2 types of venous variations related to the surgery were observed among 8 patients (15%), which have rarely been reported before.Conclusions: Personalized preoperative 3D-CT bronchography and angiography helped to clearly visualize the pulmonary anatomical structures and could contribute to the safe and efficient performance of UVATS anatomical lobectomy.

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“…Recent literature has shown subsegmentectomies to be safe, with cancer recurrence rates that are similar to segmentectomies. 1 , 3 , 4 , 5 Although further studies are needed to establish best practice guidelines regarding subsegmentectomies, they can be considered by the expert minimally invasive thoracic surgeon when dealing with tumors in difficult locations, such as the intersection of the major and minor fissures.…”

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confidence: 99%