Application of Computer-Aided Design-Modified 3D Printed Models in Video-Assisted Thoracoscopic Sublobar Resection for Early-Stage Lung Cancer
Keywords:
Computer-aided design, Thoracoscope, 3D printing, Sublobar resectionAbstract
Objective: To compare the application effects of three-dimensional visualization (3DV) models, three-dimensional printing (3DP) models, and computer-aided design (CAD)-modified 3DP models in video-assisted thoracoscopic surgery (VATS) for sublobar resection. Methods: A retrospective analysis was conducted on the clinical data of patients who underwent VATS sublobar resection at Hebei University Affiliated Hospital from November 2021 to August 2022. The patients were divided into three groups: the 3DV group, the 3DP group, and the CAD-3DP group. Perioperative data and subjective evaluations from surgeons and patients’ families were compared among the three groups. Results: A total of 22 patients were included, consisting of five males and 17 females, aged 32 to 77 (56.95 ± 12.50) years. There were nine patients in the 3DV group, six in the 3DP group, and seven in the CAD-3DP group. There were no statistically significant differences in surgical time, intraoperative blood loss, drainage volume, hospital stay, or postoperative complications among the three groups (P > 0.05). In the subjective evaluations by surgeons, the CAD-3DP group performed better than the 3DV group in terms of preoperative planning efficiency (P = 0.008), intuitiveness (P = 0.015), and ease of doctor-patient communication (P = 0.011). Compared to the 3DP group, the CAD-3DP group showed superior performance in overall satisfaction (P = 0.008), ease of preoperative planning (P = 0.015), and planning efficiency (P = 0.005). In the subjective evaluations by patients and their families, the CAD-3DP group outperformed the 3DP group in helping them understand the tumor’s surrounding vasculature (P = 0.005), surgical steps (P = 0.007), treatment plan options (P = 0.010), and overall satisfaction (P = 0.022). Compared to the 3DV group, the CAD-3DP group was better at helping patients and families understand tumor size (P = 0.013) and in overall satisfaction (P = 0.033). Conclusion: CAD-modified 3DP models offer certain advantages in preoperative planning, intraoperative navigation, and doctor-patient communication for VATS sublobar resection.
References
Saji H, Okada M, Tsuboi M, et al., 2022, Segmentectomy Versus Lobectomy in Small-Sized Peripheral Non-Small-Cell Lung Cancer (JCOG0802/WJOG4607L): A Multicentre, Open-Label, Phase 3, Randomised, Controlled, Non-Inferiority Trial. Lancet, 399(10335): 1607–1617.
Segaran N, Saini G, Mayer JL, et al., 2021, Application of 3D Printing in Preoperative Planning. J Clin Med, 10(5): 917.
Sardari Nia P, Olsthoorn JR, Heuts S, et al., 2019, Interactive 3D Reconstruction of Pulmonary Anatomy for Preoperative Planning, Virtual Simulation, and Intraoperative Guiding in Video-Assisted Thoracoscopic Lung Surgery. Innovations (Phila), 14(1): 17–26.
Ji Y, Zhang T, Yang L, et al., 2021, The Effectiveness of Three-Dimensional Reconstruction in the Localization of Multiple Nodules in Lung Specimens: A Prospective Cohort Study. Transl Lung Cancer Res, 10(3): 1474–1483.
Hamada A, Oizumi H, Kato H, et al., 2022, Outcome of Thoracoscopic Anatomical Sublobar Resection under 3-Dimensional Computed Tomography Simulation. Surg Endosc, 36(4): 2312–2320.
Hu W, Zhang K, Han X, et al., 2021, Three-Dimensional Computed Tomography Angiography and Bronchography Combined with Three-Dimensional Printing for Thoracoscopic Pulmonary Segmentectomy in Stage ⅠA Non-Small Cell Lung Cancer. J Thorac Dis, 13(2): 1187–1195.
Li C, Zheng B, Yu Q, et al., 2021, Augmented Reality and 3-Dimensional Printing Technologies for Guiding Complex Thoracoscopic Surgery. Ann Thorac Surg, 112(5): 1624–1631.
Qiu B, Ji Y, He H, et al., 2020, Three-Dimensional Reconstruction/Personalized Three-Dimensional Printed Model for Thoracoscopic Anatomical Partial-Lobectomy in Stage Ⅰ Lung Cancer: A Retrospective Study. Transl Lung Cancer Res, 9(4): 1235–1246.
Chinese Medical Association, Oncology Branch of the Chinese Medical Association, Chinese Medical Journal Press, 2018, Chinese Medical Association Guidelines for Clinical Diagnosis and Treatment of Lung Cancer (2018 Edition). Chinese Journal of Oncology, 40(12): 935–964.
Ginsberg RJ, Rubinstein LV, 1995, Randomized Trial of Lobectomy Versus Limited Resection for T1 N0 Non-Small Cell Lung Cancer. Lung Cancer Study Group. Ann Thorac Surg, 60(3): 615–622.
Suzuki K, Saji H, Aokage K, et al., 2019, Comparison of Pulmonary Segmentectomy and Lobectomy: Safety Results of a Randomized Trial. J Thorac Cardiovasc Surg, 158(3): 895–907.
Bédat B, Abdelnour-Berchtold E, Perneger T, et al., 2019, Comparison of Postoperative Complications Between Segmentectomy and Lobectomy by Video-Assisted Thoracic Surgery: A Multicenter Study. J Cardiothorac Surg, 14(1): 189.
Cao J, Yuan P, Wang Y, et al., 2018, Survival Rates After Lobectomy, Segmentectomy, and Wedge Resection for Non-Small Cell Lung Cancer. Ann Thorac Surg, 105(5): 1483–1491.
Tejo-Otero A, Buj-Corral I, Fenollosa-Artés F, 2020, 3D Printing in Medicine for Preoperative Surgical Planning: A Review. Ann Biomed Eng, 48(2): 536–555.
Xiang Z, Wu B, Zhang X, et al., 2022, Preoperative Three-Dimensional Lung Simulation Before Thoracoscopic Anatomical Segmentectomy for Lung Cancer: A Systematic Review and Meta-Analysis. Front Surg, 9: 856293.
Liu X, Zhao Y, Xuan Y, et al., 2019, Three-Dimensional Printing in the Preoperative Planning of Thoracoscopic Pulmonary Segmentectomy. Transl Lung Cancer Res, 8(6): 929–937.
Wang Y, Fang W, Chen E, 2022, Research Progress on Lung Nodule Localization. Modern Practical Medicine, 34(1): 3–6.
Chen Y, Zhang J, Chen Q, et al., 2020, Three-Dimensional Printing Technology for Localised Thoracoscopic Segmental Resection for Lung Cancer: A Quasi-Randomised Clinical Trial. World J Surg Oncol, 18(1): 223.
Yoon SH, Park S, Kang CH, et al., 2019, Personalized 3D-Printed Model for Informed Consent for Stage I Lung Cancer: A Randomized Pilot Trial. Semin Thorac Cardiovasc Surg, 31(2): 316–318.