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

摘要：

目的　通过分析对比应用与未应用IQQA三维重建系统辅助胸腔镜下肺联合亚段切除术的效果，探讨其在肺联合亚段切除术中的有效性及安全性。方法　选取2023年7月至2024年12月在珠海市人民医院行胸腔镜下肺联合亚段切除术的40例肺结节患者作为研究对象。根据患者自愿原则将是否在术前进行IQQA三维重建分为重建组（28例）和对照组（12例）。重建组男10例，女18例；年龄（55.56±12.34）岁；体重指数（23.10±1.55）kg/m²；结节大小（0.89±0.21）cm。对照组男5例，女7例；年龄（57.58±16.47）岁；体重指数（22.86±1.29）kg/m²；结节大小（0.85±0.18）cm。两组均行双孔法胸腔镜下肺联合亚段切除术。比较两组术中观察指标（手术时间、术中出血量、淋巴结清扫数目、术中手术方式更改率及中转开胸率）和术后观察指标［胸腔引流管留置时间、胸腔引流量（平均引流量）、术后并发症（肺部感染、长时间漏气、肺栓塞、乳糜胸）、住院天数及住院费用］。采用独立样本t检验和Fisher确切概率法进行统计学分析。结果　两组中转开胸率比较，差异无统计学意义（P>0.05）。重建组手术时间短于对照组［（94.15±10.71）min比（125.59±7.17）min］，术中出血量、淋巴结清扫数目、术中手术方式更改率均低于对照组［（40.57±10.35）ml比（74.33±12.18）ml、（4.89±1.26）个比（8.75±1.22）个、0比25.00%（3/12）］（均P<0.05）。两组术后并发症及住院费用比较，差异均无统计学意义（均P>0.05）。重建组胸腔引流管留置时间、胸腔引流量、住院天数均低于对照组［（3.13±0.82）d比（4.71±1.30）d、（189.92±93.81）ml比（387.83±175.04）ml、（5.27±0.94）d比（6.29±1.39）d］（均P<0.05）。结论　应用IQQA三维重建系统与胸腔镜手术结合，实现肺结节的精准切除，疗效满意，故具有较大的临床推广价值。

关键词:

胸腔镜, 肺联合亚段切除术, IQQA三维重建