초록접수 현황
| 19F-225 | 구연 발표 |
The Planning and Implementation of Segmentectomy using 3D CT Reconstruction to Achieve Adequate Surgical Margin
Ha-Eun Kim, Jee Won Suh, Go Eun Byun, Da Hee Lee, Seong Yong Park, Jin Gu Lee, Dae Joon Kim, Hyo Chae Paik, Kyung-Young Chung, Chang-Young Lee
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : Anatomical segmentectomy, which would be suitable for small sized peripheral lung cancer with sufficient surgical margin, is technically demanding. This study was aimed at seeing whether 3D CT angiography or bronchography could help plan and relevantly perform thoracoscopic segmentectomy with secure surgical margin.
Methods : 3D CT images (Fig. 1A) with thin section chest CT were obtained and planned resection margin was measured from tumor end to virtual intersegmental plane (Fig. 1B). Gross resection margin was measured with a ruler after thoracoscopic segmentectomy in operation field (Fig. 1C). Intersegmental plane during thoracoscopic segmentectomy was marked with either ICG injection (n=24, Fig. 1D) or 100% oxygen ventilation technique (n=22). Data from 46 segmentectomies for primary lung cancer (n=43) or metastatic lung cancer (n=3) performed between October 2018 and July 2019 were collected to analyze distance/tumor size ratio.
Results : All 46 cases of thoracoscopic segmentectomies were performed without any thoracotomy conversion. Mean age was 63.9 years (range, 44-83 years) and Female was 26 (57%). Mean tumor size in chest CT was 16.7mm (range, 6.0-41mm) and mean pathologic tumor size was 13.8mm (range, 5.0-35mm). The location of tumor and type of segmentectomies were summarized in Table 1. Single segmentectomy were performed in 20 cases, bi-segmentectomies in 11 cases, single segmentectomy with sub-segmentectomy in 13 cases and basal segmentectomy in 2 cases. Planned resection margin was 30.3mm (range, 11.9-59.0mm) and gross resection margin was 25.2mm (5.0-45mm). Mean distance/tumor size ratio was 1.6 (0.43-2.9).
Conclusion : Surgical planning using 3D CT reconstruction might be helpful to keep secure surgical margin.
Methods : 3D CT images (Fig. 1A) with thin section chest CT were obtained and planned resection margin was measured from tumor end to virtual intersegmental plane (Fig. 1B). Gross resection margin was measured with a ruler after thoracoscopic segmentectomy in operation field (Fig. 1C). Intersegmental plane during thoracoscopic segmentectomy was marked with either ICG injection (n=24, Fig. 1D) or 100% oxygen ventilation technique (n=22). Data from 46 segmentectomies for primary lung cancer (n=43) or metastatic lung cancer (n=3) performed between October 2018 and July 2019 were collected to analyze distance/tumor size ratio.
Results : All 46 cases of thoracoscopic segmentectomies were performed without any thoracotomy conversion. Mean age was 63.9 years (range, 44-83 years) and Female was 26 (57%). Mean tumor size in chest CT was 16.7mm (range, 6.0-41mm) and mean pathologic tumor size was 13.8mm (range, 5.0-35mm). The location of tumor and type of segmentectomies were summarized in Table 1. Single segmentectomy were performed in 20 cases, bi-segmentectomies in 11 cases, single segmentectomy with sub-segmentectomy in 13 cases and basal segmentectomy in 2 cases. Planned resection margin was 30.3mm (range, 11.9-59.0mm) and gross resection margin was 25.2mm (5.0-45mm). Mean distance/tumor size ratio was 1.6 (0.43-2.9).
Conclusion : Surgical planning using 3D CT reconstruction might be helpful to keep secure surgical margin.
책임저자: Chang-Young Lee
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Chang-Young Lee, E-mail : cyleecs@yuhs.ac