ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Effect of preoperative three-dimensional modeling on uniportal video-assisted thoracoscopic bronchial sleeve resection and early postoperative outcomes
Selcuk Gurz1, Aysen Sengul1, Yasemin Buyukkarabacak1, Mehmet Gokhan Pirzirenli1, Necmiye Gul Temel2, Yurdanur Sullu3, Asli Tanrivermis Sayit4, Hasan Gundogdu5, Ahmet Basoglu1
1Department of Thoracic Surgery, Ondokuz Mayıs University Faculty of Medicine, Samsun, Türkiye
2Department of Thoracic Surgery, Samsun Education and Research Hospital, Dr. Kamil Furtun Chest Diseases and Thoracic Surgery Hospital Additional Service Building, Samsun, Türkiye
3Department of Pathology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Türkiye
4Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Türkiye
5Department of Radiology, Samsun University Faculty of Medicine, Samsun, Türkiye
DOI : 10.5606/tgkdc.dergisi.2024.26059
Background: The aim of this study was to evaluate the effects of preoperative three-dimensional (3D) modeling on the performance of uniportal video-assisted thoracoscopic bronchial sleeve resection and early postoperative outcomes.

Methods: A total of 10 patients (5 males, 5 females; mean age: 53.8±16.9 years; range, 18 to 75 years) who underwent uniportal video-assisted thoracoscopic bronchial sleeve resection with preoperative 3D modeling between April 2021 and November 2023 were retrospectively analyzed. Preoperative 3D modeling was prepared using computed tomography with an open-source 3D software program. Demographic, clinical, intraoperative, and postoperative data of the patients were recorded. Anatomical landmarks identified by preoperative 3D modeling were compared with intraoperative findings.

Results: The anatomical landmarks created with the 3D model were in 100% agreement with the intraoperative findings. The procedures performed were three left lower lobes, three right upper lobes, one middle lobe, one right lower lobe, and one parenchyma-sparing intermediate bronchial sleeve resection. Bronchial sleeve resection was completed using uniportal video-assisted thoracoscopic technique in 90% of patients, with only one patient requiring conversion to open thoracotomy. The mean resection time was 264.2±40.5 min, and the mean anastomosis time was 86.0±20.3 min. Anastomosis times decreased with increasing experience (p=0.008). Postoperative atelectasis was observed in two patients, and there was no mortality. The mean follow-up duration was 12.2±11.8 months.

Conclusion: Preoperative 3D modeling significantly contributed to the successful implementation of uniportal video-assisted thoracoscopic bronchial sleeve resection surgery. In the future, with advancements in simulation programs, patient-specific 3D modeling is expected to benefit the identification of anatomical landmarks for bronchial sleeve resections.

Keywords : Bronchial sleeve resection, three-dimensional modeling, uniportal, video-assisted thoracoscopic surgery
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