Application of 3-dimensional reconstruction via modified pulmonary artery computed tomography angiography in anatomic pulmonary segmentectomy

Background This retrospective study aimed to summarize the application of 3 - dimensional(3D) reconstruction via modified pulmonary artery computed tomography angiography(CTA), as well as to compare the surgical outcomes of 3D versus high resolution CT(HRCT) in anatomic pulmonary segmentectomy(APS). Methods A total of 93 patients who underwent thoracoscopic APS were enrolled in the study. They were divided into 3D group (n = 30) and HRCT group (n = 63), and than matched at 1:1 ratio using the propensity score matching (PSM) method. Clinical characteristics, surgical status, and postoperative recovery were compared between two groups, additionally, variations of segmental structures were summarized. Results 60 cases were matched by PSM with 30 cases in each group. There were no significant differences between two groups in clinical characteristics, intraoperative blood loss and postoperative recovery (including total chest drainage, length of postoperative hospital stay)( P  > 0.05 for all). 8(26.7%) patients in 3D group manifesting unique variations of segmental structures underwent anatomical segmentectomy accurately. Despite the 3D group exhibited higher anatomic variations compared to the HRCT group, it demonstrated shorter operation times and lower incidence of pulmonary infection. ( P  < 0.05 for all). Conclusion Preoperative 3D reconstruction has advantages in APS, particularly for patients with complex anatomic variations. Reconstruction via modified pulmonary artery CTA is also feasible for preoperative planning and intraoperative navigation in thoracoscopic APS.