Related Experiment Video
Updated: Jul 2, 2026
Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
Preoperative assessment of the pulmonary artery by three-dimensional computed tomography before video-assisted
Kenjiro Fukuhara1, Akinori Akashi, Shigeru Nakane
1Department of General Thoracic Surgery, Takarazuka Municipal Hospital, 4-5-1 Kohama, Takarazuka, Hyogo 665-0827, Japan. ks-fukuhara@orange.plala.or.jp
Objective:
Our aim was to evaluate the efficacy of 3D imaging using multidetector row helical computed tomography (MDCT) in the preoperative assessment of the branching pattern of pulmonary artery (PA) before complete video-assisted thoracoscopic lobectomy (complete VATS lobectomy) for lung cancer.
Methods:
Forty-nine consecutive patients with clinical stage I lung cancer scheduled for complete VATS lobectomy were evaluated about branching pattern of PA on 16-channel MDCT. Intraoperative finding of the PA branching pattern were compared with the 3D-CT angiography images obtained using MDCT.
Results:
According to the intraoperative findings, 95.2% (139 of 146) of PA branches were precisely identified on preoperative 3D-CT angiography. All of the seven undetected branches were within 2mm in diameter. There was not a case that needed conversion to open thoracotomy because of intraoperative bleeding.
Conclusion:
A 3D-CT angiography using MDCT clearly revealed individual anatomies of pulmonary artery and could play an important role in safely facilitating complete VATS lobectomy procedure. However, we were unable to detect several thin branches with this technique. So, more care should be taken to avoid bleeding from these small vessels.
