Abstract：Objective To investigate the feasibility and clinical outcome of (three-dimensional) 3D reconstruction techniques for robotic-assisted anatomical segmentectomy.Methods This research is a retrospective study of 47 patients (16 males and 31 females), aged (53.15±12.19) years, who underwent chest computed tomography (CT) 3D reconstruction and robotic-assisted segmentectomy in the Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University from May 2017 to September 2018. All the patients were reconstructed in 3D in accordance with their CT image data of the chest before surgery. The maximum diameter of pulmonary nodules was (8.04±2.96) mm. The surgeon performed an anatomical segmentectomy on the basis of the reconstructed image. We collected and analyzed perioperative data.Results Preoperative 3D reconstruction accurately showed the location of pulmonary nodules and the boundaries, and the surrounding structures' relationship like the pulmonary arteries, veins and bronchus were clearly observed. All 3D reconstruction robotic-assisted anatomical segmentectomies were designed and successfully completed without transposition. A total of 40 patients underwent segmentectomy, and 7 patients underwent subsegmentectomy. The position and grade of pulmonary vessels and bronchi were observed via anatomical observation and 3D CT reconstruction. The operation time was (129.68±43.14) min. Intraoperative bleeding was (104.36±76.31) mL. Postoperative chest volume was (748.30±444.63) mL. Postoperative extubation time was (2.89±1.73) days. Postoperative hospital stay was (4.38±1.78) days. Postoperative complications were 8.5% (4/47). Postoperative pathological results showed that 42 patients had malignant tumors and 5 patients had benign lesions. All 42 patients had a negative surgical margin. The number of lymph node dissection was 7.29±5.62, and the number of lymph node dissection stations was 5.09±1.75. None of the patients experienced tumor recurrence or died after 3 months of follow-up.Conclusions Robotic-assisted segmentectomy based on preoperative 3D reconstruction is safe and effective.
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2020, Vol. 25 
