Wu YJ, Shi QT, Zhang Y, Wang YL. Thoracoscopic segmentectomy and lobectomy assisted by three-dimensional computed-tomography bronchography and angiography for the treatment of primary lung cancer. World J Clin Cases 2021; 9(34): 10494-10506 [PMID: 35004981 DOI: 10.12998/wjcc.v9.i34.10494]
Corresponding Author of This Article
Ya-Li Wang, MA, MD, Attending Doctor, Chief Doctor, Doctor, Department of Respiratory Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Minhang District, Shanghai 200127, China. wyl1586135@126.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 6, 2021; 9(34): 10494-10506 Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10494
Thoracoscopic segmentectomy and lobectomy assisted by three-dimensional computed-tomography bronchography and angiography for the treatment of primary lung cancer
Yun-Jiang Wu, Qing-Tong Shi, Yong Zhang, Ya-Li Wang
Yun-Jiang Wu, Qing-Tong Shi, Department of Thoracic Surgery, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou 225009, Jiangsu Province, China
Yong Zhang, Department of Radiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou 225009, Jiangsu Province, China
Ya-Li Wang, Department of Respiratory Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
Author contributions: Wu YJ and Wang YL analyzed and interpreted the data and wrote the article; Zhang Y and Wang YL drafted the work and collected the data; Wu YJ and Qing TS designed the study and revised the article for important intellectual content.
Supported byNational Natural Science Foundation of China, No. 81800050; Natural Science Fund of Yangzhou City, No. YZ2017119; and Science and Technology Innovation Cultivation Program of Yangzhou University, No. 2017CXJ122.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Affiliated Hospital of Yangzhou University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Li Wang, MA, MD, Attending Doctor, Chief Doctor, Doctor, Department of Respiratory Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Minhang District, Shanghai 200127, China. wyl1586135@126.com
Received: February 15, 2021 Peer-review started: February 15, 2021 First decision: July 16, 2021 Revised: July 20, 2021 Accepted: September 14, 2021 Article in press: September 14, 2021 Published online: December 6, 2021 Processing time: 288 Days and 6.3 Hours
ARTICLE HIGHLIGHTS
Research background
Performance of video-assisted thoracoscopic surgery (VATS) segmentectomy and lobectomy for primary lung cancer has currently increased. For small lung lesions, identification of the anatomical variation and intersegmental line is often difficult, and ensuring a sufficient surgical margin is more likely to be uncertain.
Research motivation
A lack of stereoscopic vision and the existence of anatomical variations create problems for surgeons during VATS, which can lead to unexpected complications.
Research objectives
The purpose of this study was to evaluate the therapeutic effect of VATS segmentectomy and lobectomy assisted by three-dimensional computed-tomography bronchography and angiography (3D-CTBA) on 123 patients.
Research methods
The 3D-CTBA during VATS segmentectomy and lobectomy was used for identifying the location of lesions, confirming anatomical variations, and securing the resection margins.
Research results
There was no intraoperative massive hemorrhages, postoperative intensive-care unit stays or 30-d mortalities. Three-dimensional navigation was performed to confirm the segmental structure, precisely cut off the targeted segment, and avoid intersegmental veins injury.
Research conclusions
The combination of VATS and 3D-CTBA worked in harmony in our study. This combination also demonstrated a new pattern of transition from lesion-directed location of tumors to computer-aided surgery for the management of small lung lesions.
Research perspectives
Intraoperative 3D-CTBA navigation could enable a more definitive VATS segmentectomy and lobectomy for early lung cancer.
