A simplified model for determining the cutting plane during thoracoscopic anatomical partial lobectomy of the right lower lobe.
Segmentectomy
computed tomography (CT)
cutting plane (CP)
intersegmental plane (ISP)
three-dimensional reconstruction (3D reconstruction)
Journal
Translational lung cancer research
ISSN: 2218-6751
Titre abrégé: Transl Lung Cancer Res
Pays: China
ID NLM: 101646875
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
15
04
2021
accepted:
16
07
2021
entrez:
25
8
2021
pubmed:
26
8
2021
medline:
26
8
2021
Statut:
ppublish
Résumé
Few studies have examined the use of two-dimensional computed tomography (2D CT) and three-dimensional (3D) reconstruction images to determine the intersegmental plane (ISP) for pulmonary segmentectomy, but a systematic approach and nomenclature are currently lacking. This current study used 3D reconstruction of CT imaging to analyze variations in the right lower lobe's pulmonary ISP and created a simplified model to determine the optimum cutting plane (CP) for clinical application for operative planning and use during thoracoscopic anatomical partial lobectomy (APL). Between January 2018 and October 2019, 325 patients with pulmonary lesions were identified who underwent thin-slice CT scans of the chest. The ISPs were identified by analyzing the 2D CT scans and 3D reconstruction images and the anatomical characteristics segmental boundary. The CP for the thoracoscopic procedure was then determined within the safe surgical margins, and a simplified CP model was created. The boundary between adjacent lung segment A and segment B was be expressed as "ISP: Sa-Sb". The ISP was divided into venous ISP (VISP), arterial ISP (AISP), and bronchial ISP (BISP). The proposed model of the CP can be expressed as follows: CP (f) = (V/A/B) ISP (x) + (V/A/B) sub ISP (y) + (V/A/B) sub-sub ISP (z). This report is a first attempt to provide a nomenclature for identifying the ISP, and create a simplified model for determining the CP for thoracoscopic partial lobectomy.
Sections du résumé
BACKGROUND
BACKGROUND
Few studies have examined the use of two-dimensional computed tomography (2D CT) and three-dimensional (3D) reconstruction images to determine the intersegmental plane (ISP) for pulmonary segmentectomy, but a systematic approach and nomenclature are currently lacking. This current study used 3D reconstruction of CT imaging to analyze variations in the right lower lobe's pulmonary ISP and created a simplified model to determine the optimum cutting plane (CP) for clinical application for operative planning and use during thoracoscopic anatomical partial lobectomy (APL).
METHODS
METHODS
Between January 2018 and October 2019, 325 patients with pulmonary lesions were identified who underwent thin-slice CT scans of the chest. The ISPs were identified by analyzing the 2D CT scans and 3D reconstruction images and the anatomical characteristics segmental boundary. The CP for the thoracoscopic procedure was then determined within the safe surgical margins, and a simplified CP model was created.
RESULTS
RESULTS
The boundary between adjacent lung segment A and segment B was be expressed as "ISP: Sa-Sb". The ISP was divided into venous ISP (VISP), arterial ISP (AISP), and bronchial ISP (BISP). The proposed model of the CP can be expressed as follows: CP (f) = (V/A/B) ISP (x) + (V/A/B) sub ISP (y) + (V/A/B) sub-sub ISP (z).
CONCLUSIONS
CONCLUSIONS
This report is a first attempt to provide a nomenclature for identifying the ISP, and create a simplified model for determining the CP for thoracoscopic partial lobectomy.
Identifiants
pubmed: 34430358
doi: 10.21037/tlcr-21-525
pii: tlcr-10-07-3203
pmc: PMC8350089
doi:
Types de publication
Journal Article
Langues
eng
Pagination
3203-3212Informations de copyright
2021 Translational Lung Cancer Research. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/tlcr-21-525). Dr. DG reported fees received from Delacroix-Chevalier (2000 Euros in 2020), Medtronic (500 euros in 2020), Ethcon (500 Euro in 2021s). The other authors have no conflicts of interest to declare.
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