The application of three-dimensional computed tomography angiography during thoracoscopic complex pulmonary segmentectomy
10.3760/cma.j.issn.1001-4497.2015.011.003
- VernacularTitle:3D-CTA重建肺血管、支气管在胸腔镜复杂肺段切除中应用
- Author:
Weibing WU
;
Lijun TANG
;
Quan ZHU
;
Xinfeng XU
;
Liang CHEN
- Publication Type:Journal Article
- Keywords:
Three-dimensional computed tomography;
Angiography;
Thoracoscopy;
Segmentectomy
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2015;31(11):649-652
- CountryChina
- Language:Chinese
-
Abstract:
Objective Identification of anatomic structures are essential for totally thoracoscopic anatomic pulmonary segmentectomies, however sometimes the procedure are difficulty.This study was to assess whether three-dimensional computed tomography angiography(3D-CTA) could contribute to the preoperative arrangement of thoracoscopic complex segmentectomy.Methods Between September 2012 and August 2014, 29 patients were performed thoracoscopic complex segmentectomies under the guidance of preoperative 3D-CTA.The segmentectomies pattern were based on the nodules' diameter, location,and pathology.The targeted vessels and bronchus were marked in preoperative simulated segmentectomies.Results Of the 29 cases, 9 right upper lobe segmentectomies, 13 left upper segmentectomies, and 7 bibasilar segmentectomies were achieved, among which 6 subsegmentectomies were also inclued.The mean lesion diameter, operative time and intraoperative blood loss were(1.35 ± 0.80) cm, (190.53 ± 50.83) min, and (26.90 ± 32.24) ml respectively.Under the guidance of preoperative 3D-CTA , 8(27.5％) nodules were detected accurately, moreover 2(6.9％) aberrant arteries and 1 (3.4％) aberrant bronchus were observed.According to the marked vessels and bronchus preoperatively, 27 (93.1％) arteries, 25 (86.2％)veins,and 29(100％) bronchus were identified and dissected in the operation.Three cases converted to unplanned segmentectomies.No serious complications or death occurred.Conclusion 3D-CTA is an effective tool to enhance security and efficiency in thoracoscopic complex anatomical segmentectomy.
