Complete video-assisted thoracoscopic multi-subsegmentectomy based on patients' specific virtual 3-D pulmonary models

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Video-assisted thoracoscopic surgery (VATS) is standard for early-stage non-small cell lung cancer (NSCLC).
• Segmentectomy and subsegmentectomy demand precise knowledge of lung 3-D bronchovascular anatomy.
• Previous work established the utility of patient-specific 3-D pulmonary models for VATS.

Purpose of the Study:

• To investigate the feasibility and outcomes of multi-segmentectomy for non-small cell lung cancer.
• To evaluate the application of 3-D pulmonary models in guiding thoracoscopic multi-subsegmentectomy.

Main Methods:

• Retrospective analysis of 11 patients undergoing VATS multi-subsegmentectomy between July 2001 and January 2012.
• Preoperative simulation using virtual 3-D pulmonary models for surgical planning.
• Assessment of patient demographics, tumor characteristics, surgical procedures, and postoperative outcomes.

Main Results:

• The study included 11 patients (mean age 69.2 years) with various NSCLC histological types and tumor sizes.
• All procedures were completed thoracoscopically without conversion to thoracotomy, achieving macroscopically negative margins.
• Three patients experienced prolonged air leaks (>6 days); no pulmonary vessel injuries were reported.

Conclusions:

• Video-assisted thoracoscopic multiple subsegmentectomy is a viable surgical option for selected non-small cell lung cancer patients.
• The use of reconstructed 3-D pulmonary models enhances surgical precision and feasibility.
• This approach can achieve adequate resection margins in complex lung cancer cases.