Three-Dimensional Imaging-Guided Lung Anatomic Segmentectomy: A Single-Center Preliminary Experiment
<i>Background and objectives</i>: VATS segmentectomy has been proven to be effective in the treatment of stage I NSCLC, but its technical complexity remains one of the most challenging aspects for thoracic surgeons. Furthermore, 3D-CT reconstruction images can help in planning and perfor...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/12/2079 |
| _version_ | 1797380148369031168 |
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| author | Giorgio Cannone Vincenzo Verzeletti Alberto Busetto Luigi Lione Alessandro Bonis Samuele Nicotra Alessandro Rebusso Marco Mammana Marco Schiavon Andrea Dell’Amore Federico Rea |
| author_facet | Giorgio Cannone Vincenzo Verzeletti Alberto Busetto Luigi Lione Alessandro Bonis Samuele Nicotra Alessandro Rebusso Marco Mammana Marco Schiavon Andrea Dell’Amore Federico Rea |
| author_sort | Giorgio Cannone |
| collection | DOAJ |
| description | <i>Background and objectives</i>: VATS segmentectomy has been proven to be effective in the treatment of stage I NSCLC, but its technical complexity remains one of the most challenging aspects for thoracic surgeons. Furthermore, 3D-CT reconstruction images can help in planning and performing surgical procedures. In this paper, we present our personal experience of 11 VATS anatomical resections performed after accurate pre-operative planning with 3D reconstructions. <i>Materials and methods</i>: A 3D virtual model of the lungs, airways, and vasculature was obtained, starting from a 1.25 mm 3-phase contrast CT scan, and the original images were used for the semi-automatic segmentation of the lung parenchyma, airways, and tumor. <i>Results</i>: Six males and five females were included in this study. The median diameter of the pulmonary lesion at the pre-operative chest CT scan was 20 mm. The surgical indication was confirmed in seven patients: in three cases, a lobectomy, instead of a segmentectomy, was needed due to intraoperative findings of nodal metastasis. Meanwhile, only in one case, we performed a lobectomy because of inadequate surgical resection margins. Skin-to-skin operative average time was 142 (IQR 1-3 105–182.5) min. The median post-operative stay was 6 (IQR 1-3 3.5–7) days. The mean value of the closest surgical margin was 13.7 mm. <i>Conclusion</i>: Image-guided reconstructions are a useful tool for surgeons to perform complex resections in order to spare healthy parenchyma and to ensure disease-free margins. Nevertheless, human skill and surgeon experience still remain fundamental for the final decisions regarding the proper resection to perform. |
| first_indexed | 2024-03-08T20:33:26Z |
| format | Article |
| id | doaj.art-b36eaec240cb4ca2a15c3ff5a753b583 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-08T20:33:26Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-b36eaec240cb4ca2a15c3ff5a753b5832023-12-22T14:23:44ZengMDPI AGMedicina1010-660X1648-91442023-11-015912207910.3390/medicina59122079Three-Dimensional Imaging-Guided Lung Anatomic Segmentectomy: A Single-Center Preliminary ExperimentGiorgio Cannone0Vincenzo Verzeletti1Alberto Busetto2Luigi Lione3Alessandro Bonis4Samuele Nicotra5Alessandro Rebusso6Marco Mammana7Marco Schiavon8Andrea Dell’Amore9Federico Rea10Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, ItalyThoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, ItalyThoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, ItalyThoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, ItalyThoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, ItalyThoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, ItalyThoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, ItalyThoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, ItalyThoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, ItalyThoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, ItalyThoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy<i>Background and objectives</i>: VATS segmentectomy has been proven to be effective in the treatment of stage I NSCLC, but its technical complexity remains one of the most challenging aspects for thoracic surgeons. Furthermore, 3D-CT reconstruction images can help in planning and performing surgical procedures. In this paper, we present our personal experience of 11 VATS anatomical resections performed after accurate pre-operative planning with 3D reconstructions. <i>Materials and methods</i>: A 3D virtual model of the lungs, airways, and vasculature was obtained, starting from a 1.25 mm 3-phase contrast CT scan, and the original images were used for the semi-automatic segmentation of the lung parenchyma, airways, and tumor. <i>Results</i>: Six males and five females were included in this study. The median diameter of the pulmonary lesion at the pre-operative chest CT scan was 20 mm. The surgical indication was confirmed in seven patients: in three cases, a lobectomy, instead of a segmentectomy, was needed due to intraoperative findings of nodal metastasis. Meanwhile, only in one case, we performed a lobectomy because of inadequate surgical resection margins. Skin-to-skin operative average time was 142 (IQR 1-3 105–182.5) min. The median post-operative stay was 6 (IQR 1-3 3.5–7) days. The mean value of the closest surgical margin was 13.7 mm. <i>Conclusion</i>: Image-guided reconstructions are a useful tool for surgeons to perform complex resections in order to spare healthy parenchyma and to ensure disease-free margins. Nevertheless, human skill and surgeon experience still remain fundamental for the final decisions regarding the proper resection to perform.https://www.mdpi.com/1648-9144/59/12/2079three-dimensional reconstructionlung cancerVATS segmentectomy |
| spellingShingle | Giorgio Cannone Vincenzo Verzeletti Alberto Busetto Luigi Lione Alessandro Bonis Samuele Nicotra Alessandro Rebusso Marco Mammana Marco Schiavon Andrea Dell’Amore Federico Rea Three-Dimensional Imaging-Guided Lung Anatomic Segmentectomy: A Single-Center Preliminary Experiment Medicina three-dimensional reconstruction lung cancer VATS segmentectomy |
| title | Three-Dimensional Imaging-Guided Lung Anatomic Segmentectomy: A Single-Center Preliminary Experiment |
| title_full | Three-Dimensional Imaging-Guided Lung Anatomic Segmentectomy: A Single-Center Preliminary Experiment |
| title_fullStr | Three-Dimensional Imaging-Guided Lung Anatomic Segmentectomy: A Single-Center Preliminary Experiment |
| title_full_unstemmed | Three-Dimensional Imaging-Guided Lung Anatomic Segmentectomy: A Single-Center Preliminary Experiment |
| title_short | Three-Dimensional Imaging-Guided Lung Anatomic Segmentectomy: A Single-Center Preliminary Experiment |
| title_sort | three dimensional imaging guided lung anatomic segmentectomy a single center preliminary experiment |
| topic | three-dimensional reconstruction lung cancer VATS segmentectomy |
| url | https://www.mdpi.com/1648-9144/59/12/2079 |
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