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Hirohisa Horinouchi



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    P1.16 - Surgery (ID 702)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P1.16-019 - Three Dimensional CT Angio-Bronchography Doesn't Contribute to the Shortening of the Operation Time in Segmentectomy (ID 9869)

      09:30 - 16:00  |  Presenting Author(s): Hirohisa Horinouchi

      • Abstract
      • Slides

      Background:
      In the field of surgical treatment for lung malignancy, segmentectomy has been accepted as a choice of surgical resection for some of early lung cancer cases, for patients with poor ventilatory function, and for some of metastatic lung tumor cases. Meanwhile, thoracic surgeons are familiar with the variety of branching pattern of pulmonary vessels as well as bronchial tree. Before each surgery, surgeons usually reconstruct the branching image from CT. Recently three dimensional angio-bronchography (3D-CTAB) is easily retrieved from the DICOM data of Dynamic CT. Reconstructed 3D-CTangiography has been shown its contribution to the enhancement of the safety of various field of surgery. We conducted a retrospective research whether 3D-CTAB can shorten operation time in segmentectomy cases with lung tumor.

      Method:
      During May 2012 through May 2017, we conducted lung resection for 272 cases. Among them 39 procedures are segmentectomy that consist of 35 lung neoplasm cases and 4 inflammatory cases. We analyze 35 lung neoplasm cases. Demography of patients are as follows, Male/Female 20/15, Age range 44-87y/o (mean 68.5), operation time was distributed 131-281 minutes (mean 182); blood loss was 1-252ml (mean 37ml). 17 cases underwent surgery without 3DCTAB and remaining 18 cases underwent surgery after 3DCTAB image reconstruction.

      Result:
      Operation time was 196+/-40min in non 3DCTAB group 173+/-35min in 3DCTAB group. Blood loss was 43.2+/-59.3ml in non-3DCTAB group and 31.2+/-19.8ml in 3DCTAB group. Statistically there are no significant differences between non3DCTAB group and 3DCTAB group in regards to operation time and blood loss. We conducted subgroup analysis. When S6 segmentectomy and lingulectomy were defined as basic procedures (n=17) and remaining segmentectomy procedures as complex procedures (n=18) and analyze the effect of 3DCTAB. There are still no significant differences between non3DCTAB group and 3DCTAB group in regards to operation time and blood loss.

      Conclusion:
      It seemed that 3DCTAB didn’t contribute to the shortening of the operation time and decrease of blood loss during surgery. However, surgeons perceive that 3DCTAB enhances the safety of surgery and leads to precision medicine.

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