三维重建在RS9节段切除术中右前、外侧、后基段(RS8、RS9、RS10)解剖分析中的临床应用

IF 4 2区 医学 Q2 ONCOLOGY
Translational lung cancer research Pub Date : 2025-02-28 Epub Date: 2025-02-21 DOI:10.21037/tlcr-2024-1231
Jiafu Zhu, Sui Chen, Yukang Lin, Jiangshan Huang, Marcus Taylor, Junji Ichinose, Yeon Wook Kim, Zihao Zheng, Jinyang Shi, Litao Yang, Jiangbo Lin
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引用次数: 0

摘要

背景:解剖RS9节段切除术具有挑战性,因为涉及复杂的节段间平面(ISPs)和多种解剖结构,很少有研究对RS9节段的解剖和外科手术的三维(3D)重建技术进行了强有力的评估。本研究旨在分析三维重建右基段前、外侧、后基段(RS8、RS9、RS10)血管和支气管分支形态在解剖性RS9节段切除术中的应用。方法:对2020年5月至2022年5月期间354例患者使用Mimics 21.0 (Materialise)软件进行血管和支气管分支形态的三维重建进行回顾性分析。根据术前及术中三维重建资料,对27例患者进行解剖性RS9节段切除术,并对手术结果进行回顾性分析。结果:右侧基底支气管(B8、B9、B10)支型分为B8型和B9+10型(74.6%);B8+9和B10型(15.3%);B8、B9、B10型(10.2%)。右基底动脉(A8、A9、A10)分支形态分为简单分岔型(A8、A9+10型占62.4%、A8+9、A10型占13.0%)、分裂分岔型(A8、A8+9+10型占18.4%、A8+9、A9+10型占3.7%)、三叉型(A8、A9、A10型占2.5%)。右侧基底静脉(V8、V9、V10)分支形态复杂,可分为简单分岔型、分裂分岔型和三叉型,又可分为10个亚型。其中,以V8+9和V10型、V8+9+10和V10型、V8+9和V9+10型最为常见,分别占29.4%、25.4%和21.5%。27例患者均成功完成解剖性RS9节段切除术,未转开胸。结论:三维重建是分析RS8、RS9、RS10支气管血管分支形态的实用工具。三维重建在解剖性RS9节段切除术中的应用是安全可行的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical application of three-dimensional reconstruction in anatomical analysis of the right anterior, lateral, and posterior basal segments (RS8, RS9, and RS10) for RS9 segmentectomy.

Background: Anatomical RS9 segmentectomy is challenging due the intricate intersegmental planes (ISPs) and varied anatomical structures involved, with few studies having robustly assessed the three-dimensional (3D) reconstruction techniques for the anatomy and surgical procedures of the RS9 segment. This study aimed to analyze the application of 3D reconstruction for the vascular and bronchial branching patterns of the right anterior, lateral, and posterior basal segments (RS8, RS9, and RS10, respectively) for anatomical RS9 segmentectomy.

Methods: From May 2020 to May 2022, 3D reconstructions of 354 patients were retrospectively analyzed in terms of vascular and bronchial branching patterns using Mimics 21.0 (Materialise). Based on the preoperative and intraoperative 3D reconstruction data, anatomical RS9 segmentectomy was performed in 27 patients, and the surgical outcomes were retrospectively analyzed.

Results: The branching patterns of the right basal bronchi (B8, B9, and B10) were divided into the B8 and B9+10 type (74.6%); the B8+9 and B10 type (15.3%); and the B8, B9, and B10 type (10.2%). The branching patterns of the right basal arteries (A8, A9, and A10) were classified into a simple bifurcated type [the A8 and A9+10 type (62.4%) and the A8+9 and A10 type (13.0%)], split bifurcated type [the A8 and A8+9+10 type (18.4%) and the A8+9 and A9+10 type (3.7%)], and trifurcated type [the A8, A9, and A10 type (2.5%)]. The branching patterns of the right basal veins (V8, V9, and V10) were complex and were classified into simple bifurcated, split bifurcated, and trifurcated types and further divided into 10 subtypes. Of these types, the V8+9 and V10 type, the V8+9+10 and V10 type, and the V8+9 and V9+10 type were the most common, accounting for 29.4%, 25.4%, and 21.5% of the cases, respectively. Anatomical RS9 segmentectomy was successfully completed without conversion to thoracotomy in all 27 patients.

Conclusions: 3D reconstruction is a practical tool for analyzing the bronchovascular branching patterns of RS8, RS9, and RS10. The application of 3D reconstruction is safe and feasible in anatomical RS9 segmentectomy.

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来源期刊
CiteScore
7.20
自引率
2.50%
发文量
137
期刊介绍: Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.
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