Utility of preoperative three-dimensional CT bronchography and angiography in uniportal video-assisted thoracoscopic anatomical lobectomy : a retrospective propensity score-matched analysis
2021 Annals of Translational Medicine. All rights reserved..
BACKGROUND: Personalized three-dimensional (3D) reconstruction can help surgeons to overcome technical challenges and variations of pulmonary anatomic structures in the performance of uniportal video-assisted thoracoscopic surgery (UVATS), thus improving the safety and efficacy of the procedure. This study aims to evaluate the utility of preoperative 3D-CT bronchography and angiography (3D-CTBA) with Exoview software in the assessment of anatomical variations of pulmonary vessels, and to analyze short-term surgical outcomes in patients undergoing UVATS lobectomy.
METHODS: We retrospectively analyzed the data of 198 consecutive patients who underwent curative UVATS lobectomy between November 2019 and September 2020. The patients were divided into an "Exoview" group (n=53) and a "non-Exoview" group (n=145). We performed 1:1 propensity score matching and compared intraoperative and postoperative outcomes between the two groups. A subgroup analysis of 74 patients who underwent single-direction uniportal lobectomy was also conducted. Aberrant pulmonary vessel patterns related to the surgery were also examined.
RESULTS: The operative time in the Exoview group was significantly shorter than that in the non-Exoview group, both before (145.7±33.9 vs. 159.5±41.6 minutes, P=0.032) and after (145.7±33.9 vs. 164.2±41.8 minutes, P=0.014) propensity score matching. The number of mediastinal lymph nodes dissected was higher in the Exoview group than in the non-Exoview group (8.19±6.89 vs. 5.78±3.3, P=0.024) after propensity score matching. Intraoperative blood loss showed a statistical difference between the Exoview and non-Exoview groups (60.4±45.4 vs. 100.8±83.9, P=0.009). Four types of arterial variations and 2 types of venous variations related to the surgery were observed among 8 patients (15%), which have rarely been reported before.
CONCLUSIONS: Personalized preoperative 3D-CT bronchography and angiography helped to clearly visualize the pulmonary anatomical structures and could contribute to the safe and efficient performance of UVATS anatomical lobectomy.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
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| Enthalten in: |
Annals of translational medicine - 9(2021), 6 vom: 25. März, Seite 480 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zhu, Xin-Yu [VerfasserIn] |
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| Links: |
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Journal Article |
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| Anmerkungen: |
Date Revised 22.04.2022 published: Print Citation Status PubMed-not-MEDLINE |
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| doi: |
10.21037/atm-21-474 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM324057105 |
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| 100 | 1 | |a Zhu, Xin-Yu |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Utility of preoperative three-dimensional CT bronchography and angiography in uniportal video-assisted thoracoscopic anatomical lobectomy |b a retrospective propensity score-matched analysis |
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| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a 2021 Annals of Translational Medicine. All rights reserved. | ||
| 520 | |a BACKGROUND: Personalized three-dimensional (3D) reconstruction can help surgeons to overcome technical challenges and variations of pulmonary anatomic structures in the performance of uniportal video-assisted thoracoscopic surgery (UVATS), thus improving the safety and efficacy of the procedure. This study aims to evaluate the utility of preoperative 3D-CT bronchography and angiography (3D-CTBA) with Exoview software in the assessment of anatomical variations of pulmonary vessels, and to analyze short-term surgical outcomes in patients undergoing UVATS lobectomy | ||
| 520 | |a METHODS: We retrospectively analyzed the data of 198 consecutive patients who underwent curative UVATS lobectomy between November 2019 and September 2020. The patients were divided into an "Exoview" group (n=53) and a "non-Exoview" group (n=145). We performed 1:1 propensity score matching and compared intraoperative and postoperative outcomes between the two groups. A subgroup analysis of 74 patients who underwent single-direction uniportal lobectomy was also conducted. Aberrant pulmonary vessel patterns related to the surgery were also examined | ||
| 520 | |a RESULTS: The operative time in the Exoview group was significantly shorter than that in the non-Exoview group, both before (145.7±33.9 vs. 159.5±41.6 minutes, P=0.032) and after (145.7±33.9 vs. 164.2±41.8 minutes, P=0.014) propensity score matching. The number of mediastinal lymph nodes dissected was higher in the Exoview group than in the non-Exoview group (8.19±6.89 vs. 5.78±3.3, P=0.024) after propensity score matching. Intraoperative blood loss showed a statistical difference between the Exoview and non-Exoview groups (60.4±45.4 vs. 100.8±83.9, P=0.009). Four types of arterial variations and 2 types of venous variations related to the surgery were observed among 8 patients (15%), which have rarely been reported before | ||
| 520 | |a CONCLUSIONS: Personalized preoperative 3D-CT bronchography and angiography helped to clearly visualize the pulmonary anatomical structures and could contribute to the safe and efficient performance of UVATS anatomical lobectomy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Uniportal video-assisted thoracoscopic surgery (UVATS) | |
| 650 | 4 | |a single-direction lobectomy | |
| 650 | 4 | |a three-dimensional computed tomography bronchography and angiography (3D-CTBA) | |
| 700 | 1 | |a Yao, Fei-Rong |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Chun |e verfasserin |4 aut | |
| 700 | 1 | |a Ding, Cheng |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Wen-Yi |e verfasserin |4 aut | |
| 700 | 1 | |a Pan, Liu-Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Chang |e verfasserin |4 aut | |
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