Thoracoscopic segmentectomy and lobectomy assisted by three-dimensional computed-tomography bronchography and angiography for the treatment of primary lung cancer

Figure 3 Identification of sufficient surgical margin and preoperative surgery simulation. A: Chest computed tomography (CT) scan showed pure ground-glass opacity in the right upper lobe; B: We simulated surgery preoperatively, guided by a three-dimensional computed-tomography bronchography and angiography (3D-CTBA) images. The image showed that the targeted segmental structures needing to be successively resected were the V³c, A³b, B³b, and V³b; C: We precisely identified sufficient surgical margin after calculating the distance from the lesion to the predetermined cutting margin on the 3D-CTBA image. The safety margin was defined as a sphere extending at least 2 cm outside the lesion or 2 cm greater than the tumor size; D: The yellow area denotes the extent of targeted lung parenchyma RS³b. Afterward, we meticulously performed segmentectomy of the RS³b, as illustrated in Figure 4.