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Three-Dimensional Images for Thoracoscopic Segmentectomy: An Alternative to Preoperative Localization
Yining Zhu1, Ming Luo1, Jian Wang1
1Department of Thoracic Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
The Journal of Surgical Research
|February 12, 2025
Summary
Preoperative localization did not improve resection success or margins in three-dimensional (3D) image-guided video-assisted thoracic surgery (VATS) segmentectomy for small lung nodules. However, avoiding localization reduced postoperative complications.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Medical Imaging
Background:
- Video-assisted thoracic surgery (VATS) segmentectomy is a minimally invasive approach for early-stage lung cancer.
- Resection of small pulmonary nodules can be challenging.
- Three-dimensional (3D) image-guided VATS utilizes advanced imaging for precision.
Purpose of the Study:
- To compare the outcomes of 3D image-guided VATS segmentectomy with and without preoperative localization for small pulmonary nodules.
- To evaluate the impact of preoperative localization on resection success, surgical margins, and postoperative complications.
Main Methods:
- A retrospective study of 439 patients undergoing 3D image-guided VATS segmentectomy for early-stage lung cancer.
- Patients were divided into two groups: preoperative localization (n=96) and no preoperative localization (n=343).
- Primary endpoints included resection success rate and surgical margins.
Main Results:
- Resection success rates were comparable (99.0% vs. 99.1%, P=1.000).
- Surgical margins were similar (median 20 mm vs. 22 mm, P=0.410).
- Overall complications were significantly higher in the localization group (9.4% vs. 4.1%, P=0.040).
Conclusions:
- 3D image-guided VATS segmentectomy with and without preoperative localization yield comparable resection success and margins.
- Performing VATS segmentectomy without preoperative localization is associated with fewer postoperative complications.
- Preoperative localization is not essential for achieving successful outcomes in this procedure.
