ObjectiveTo observe the clinical effect of thoracoscopic precise pulmonary segmentectomy in the treatment of pulmonary ground-glass nodules. MethodsThe clinical data of 61 patients with pulmonary ground-glass nodules who underwent thoracoscopic precise pulmonary segmentectomy were analyzed retrospectively. Before operation, three-dimensional computed tomography bronchography and angiography (3D-CTBA) was performed with Mimics software to identify the target vessels and bronchus, and to plan the surgical approach. The operation related indexes, postoperative complications, postoperative pathological results and follow-up were analyzed in patients. ResultsThe operations completed in 61 patients via thoracoscopy, without conversion to the open operation. The operation time was (157.2±32.2) min, the intraoperative blood loss was (31.6±28.4) mL, the mean postoperative indwelling time of chest tube was 4 d, and the mean postoperative hospital stays were 7 d. The patients with non-small cell lung cancer (NSCLC) underwent routine lymph node sampling. A total of 448 lymph nodes were sampled, with an average of (8.3±3.7). No lymph node metastasis was found. Postoperative complications expressed as 1 case of pulmonary infection, 1 case of chylothorax, 6 cases of pulmonary air leakage, 2 cases of a small amount of hemoptysis, and 3 cases of arrhythmia. Among the 61 patients, 8 cases interpreted in benign pulmonary nodules (two pulmonary nodules pathologies in one of the patients revealed atypical adenomatous hyperplasia and chondroma, respectively), and 53 cases had malignant pulmonary nodules, including 2 cases of metastatic lung cancer and 51 cases of NSCLC. A regular follow-up for 12 to 36 months was conducted in 59 patients with operation (2 patients with metastatic lung cancer were excluded). There was no distant metastasis or recurrence, and no death occurred in the patients during the follow-up period. ConclusionEmploying thoracoscopic precise pulmonary segmentectomy on pulmonary ground-glass nodules with the support of 3D-CTBA technology is conducive to the operators to plan a detailed surgical scheme before operation, and to exquisitely conduct during operation, so as to reduce the risk of surgery, and to decrease the incidence of complications, as well as to improve the quality of life in patients. It is a safe and effective treatment method, which is worthy of promotion and application.

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