Clinical application of three-dimensional computed tomography bronchography and angiography in thoracoscopic segmentectomy

Abstract

Objective To explore the clinical value of three-dimensional computed tomography bronchography and angiography (3D-CTBA) in thoracoscopic dissection or combined segmentectomy. Methods The clinical data of 30 patients with isolated or multiple pulmonary nodules from September 2017 to August 2019 were retrospectively analyzed. All cases were treated with 3D-CTBA to locate the nodules accurately before operations, in order to explicit the courses of bronchi and vessels, and to observe the variations. The target bronchi, arteries and veins were resected accurately during the operations, and the intersegmental plane was determined by expansion-collapse method. Results 13 patients underwent segmentectomy and 17 patients underwent combined segmentectomy. The diameter of the nodule was (11.56±3.79)mm; the depth of the nodule (the shortest distance from the visceral pleura) was (13.88±3.96)mm; the operation time was (134.94±18.68)min, and the intraoperative bleeding volume was (94.38±37.94)ml. No cancer metastasis was found by rapid pathological examination of lymph nodes during operations. No conversion to thoracotomy. The indwelling time of thoracic tube was (3.69±1.30)days, and the hospitalization days after operations was (4.81±1.47)days. No serious complications or death during the perioperative period. Conclusions Preoperative 3D-CTBA has advantages in pulmonary segmentectomy, which is a safe and effective method for accurate segmentectomy. Key words: Imaging, three-dimensional; Bronchography; Thoracoscopy; Pneumonectomy