关键词:

胸腔镜, 肺联合亚段切除术, IQQA三维重建

Abstract:

Objective　By analyzing and comparing the effect of the application and non-application of IQQA three-dimensional reconstruction system assisted thoracoscopic subsegmental pulmonary resection, the effectiveness and safety of the subsegmental pulmonary resection were discussed. Methods　Forty patients with pulmonary nodules who underwent thoracoscopic combined subsegmental resection in Zhuhai People's Hospital from July 2023 to December 2024 were selected as the study subjects. According to the principle of patient's voluntary consent, whether to perform the three-dimensional IQQA reconstruction before the operation was divided into the reconstruction group (28 cases) and the control group (12 cases). The reconstruction group included 10 males and 18 females; the average age was (55.56±12.34) years; the body mass index was (23.10±1.55) kg/m²; the size of the nodules was (0.89±0.21) cm. The control group included 5 males and 7 females; the average age was (57.58±16.47) years; the body mass index was (22.86±1.29) kg/m²; the size of the nodules was (0.85±0.18) cm. Both groups underwent bilateral thoracoscopic combined subsegmental pulmonary resection. The intraoperative observation indicators were compared between the two groups (operation time, intraoperative blood loss, number of lymph node dissections, rate of intraoperative surgical modification, and rate of conversion to open surgery) and the postoperative observation indicators [duration of chest drainage tube placement, thoracic drainage volume (average drainage volume), postoperative complications (pulmonary infection, prolonged air leakage, pulmonary embolism, and chylothorax), length of hospital stay, and hospitalization expenses]. Independent sample t test, and Fisher's exact probability method were used for statistical analysis. Results　There was no statistically significant difference in the rate of conversion to open surgery between the two groups (P>0.05). The operation time of the reconstruction group was shorter than that of the control group [(94.15±10.71) min vs. (125.59±7.17) min], and the intraoperative blood loss, the number of lymph node dissections, and the rate of intraoperative surgical modification were all lower in the reconstruction group [(40.57±10.35) ml vs. (74.33±12.18) ml, (4.89±1.26) vs. (8.75±1.22), 0 vs. 25.00% (3/12)] (all P<0.05). There was no statistically significant difference in the postoperative complications and hospitalization expenses between the two groups (both P>0.05). The duration of chest drainage tube placement, the thoracic drainage volume, and the length of hospital stay in the reconstruction group were all lower than those in the control group [(3.13±0.82) d vs. (4.71±1.30) d, (189.92±93.81) ml vs. (387.83±175.04) ml, (5.27±0.94) d vs. (6.29±1.39) d] (all P<0.05). Conclusions　By combining the IQQA three-dimensional reconstruction system with thoracoscopic surgery, precise resection of pulmonary nodules was achieved, with satisfactory therapeutic effects. Therefore, it has considerable clinical application value.

Key words:

Thoracoscopy, Pulmonary combined subsegmentectomy, IQQA three-dimensional reconstruction