scholarly journals Clinical Application of Three-Dimensional Reconstruction Technique in Thoracoscopic Pneumonectomy

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Dong Li ◽  
Zhanxin Li ◽  
Libin Li ◽  
Jiangmin Zheng ◽  
Qingwei Wang ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Blood Vessels ◽  
Preoperative Planning ◽  
Three Dimensional ◽  
Pulmonary Nodules ◽  
Segmental Resection ◽  
Reconstruction Technique ◽  
Three Dimensional Reconstruction ◽  
Tube Removal ◽  
Dimensional Reconstruction

Objective. To investigate the clinical value of 3D computed tomography bronchoangiography (3D CTBA) in thoracoscopic anatomical lung segment resection or combined lung segment resection. Methods. The clinical data of 25 patients with non-small-cell lung cancer who underwent thoracoscopic radical lobectomy and pulmonary segmentectomy with pulmonary nodules were retrospectively analyzed. All patients underwent preoperative thin-slice CT scan, and the bronchus, pulmonary artery, and pulmonary vein were reconstructed by DeepInsight software. Meanwhile, pulmonary nodules, tumors, or enlarged lymph nodes were reconstructed. Accurate preoperative planning was carried out through preoperative reconstruction of three-dimensional images, especially the variation of pulmonary bronchus and blood vessels, the relationship between tumors and enlarged lymph nodes and pulmonary blood vessels, and the precise positioning of pulmonary nodules in pulmonary segments. Compared with preoperative three-dimensional reconstruction, intraoperative real-time navigation can achieve accurate operation. The intraoperative conversion to thoracotomy, operative time, intraoperative bleeding and postoperative hospitalization time, drainage tube removal time and total drainage volume, and the incidence of perioperative complications were recorded. Results. The anatomical structure and variation of bronchus and pulmonary vessels were clearly reconstructed in all patients, and the reconstruction of the relationship between central tumor and enlarged lymph nodes and blood vessels was satisfactory. The location of pulmonary nodules in pulmonary segments was clearly defined, and preoperative planning was performed accurately. All patients underwent real-time intraoperative navigation, and precise surgery was performed according to the preoperative planning. The operation was successfully completed without any transfer to thoracotomy or intraoperative accidental bleeding. The operative time was (147.60 ± 37.77) min, the intraoperative blood loss was (33.82 ± 22.17) mL, the postoperative hospital stay was (7.02 ± 1.78) d, drainage tube removal time was (4.68 ± 1.60) d, and postoperative total drainage volume was (221.00 ± 135.03) mL; there were no severe complications and no death during perioperative period. Conclusion. The application of three-dimensional reconstruction technique for preoperative evaluation and subsequent thoracoscopic pulmonary segmental resection can achieve accurate, safe, and effective pulmonary segmental resection, reduce the difficulty of thoracoscopic pulmonary segmental resection, reduce the risk of surgery, and improve the surgical effect.

scholarly journals Features of Blood Supply to the Bones of the Lower Leg in the Ankle Joint Region

2021 ◽  
Vol 6 (6) ◽  
pp. 74-79
Author(s):  
I. Yu. Oliinyk ◽  
◽  
O. V. Tsyhykalo ◽  
O. A. Koval
Keyword(s):  
Bone Marrow ◽  
Blood Vessels ◽  
Three Dimensional ◽  
Prenatal Development ◽  
Lower Leg ◽  
Three Dimensional Reconstruction ◽  
Distal Metaphysis ◽  
Nutrient Foramina ◽  
Dimensional Reconstruction ◽  
Upper Third

The purpose of the study was to investigate the topography of permeable (nutrition) arteries in the lower third of leg during human ontogenesis. Materials and methods. The research was conducted on 30 specimens of human prefetuses and fetuses aged 3-9 months of prenatal development; 28 bone specimens of adult tibia and fibula and 27 series of computerized tomography scans of lower extremities of adults aged 21-72 were used. We have used a complex of methods for morphological research: anthropometry, morphometry, macromicroscopy, injections of blood vessels of X-ray contrasting mixtures, three-dimensional reconstruction and statistical analysis. Results and discussion. Cartilage osteogenesis occurs in the prefetal period of prenatal human development, in which blood vessels play a crucial morphofunctional role. During endochondral ossification of the tibia, the vessels of the bone cuff grow into the diaphysis of the cartilaginous model of the bone and osteogenic cells go beyond their limits. In the third trimester of prenatal development, blood vessels grow into the epiphyseal part of the cartilaginous model and an epiphyseal centre of ossification forms. Between the epiphysis and diaphysis centers of ossification, a metaphysical growth plate forms that develops intraosseous anastomosis between the diaphyseal and metaphysical blood vessels. In the metaphysis region, there are extra-skeletal anastomoses. Often, the insertion of nutrition arteries into the bone of the tibia is usually the middle third of bones (55%) and distal metaphysis (37%). In 10%, there were nutrition foramina in the upper third of the tibia. Three-dimensional reconstruction also clearly shows a more extensive and developed network of vessels in the bone marrow canal in metaphysical regions. In the middle third of the tibia and fibula, 1-3 nutrient foramina can be traced on most specimens. On the fibular, in addition to the posterior-medial localization of the nutrient arteries, there were variants with a "high" (above the metaphysis) placement of the entrance of the vessel into the bone substance. Conclusion. The most common places where arteries enter the bones of the lower leg are the middle third of the bones (55%) and the distal metaphysis (37%). In 10%, there were nutrient foramina in the upper third of the tibia. The three-dimensional reconstruction also clearly shows a more extensive and developed network of vessels in the bone marrow canal in metaphysical regions. During the postnatal period, we most often encountered the localization of nutritional arteries on the anterior-lateral surface of the tibia (23%), or their combination – the presence of both nutrient arteries on the posterior and medial bone surfaces (18.3%)

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