With this project we want to study the effectiveness of 3D reconstruction of preoperative CT to reduce operating times, blood loss and conversions after segmentectomy performed in thoracoscopy / robotics.
Pulmonary segmentectomy is the surgery of first choice in malignant lung tumors with a diameter \<2 cm in diameter. Patients who are candidates for this type of treatment perform usually a preoperative CT scan with two-dimensional reconstructions (2D: axial, coronary and sagittal). Today it is possible to perform a preoperative three-dimensional reconstruction (3D: volume rendering) of the vessels and bronchi using special software. Objectives of the study is to analyze, in these patients, the benefits of 3D reconstruction of vessels and bronchi compared to 2D reconstruction, analyzing intra- and post-operative data.The study aims to randomize 288 patients over 36 months. Study design: Prospective, randomized, controlled study. In 50% of patients the preoperative study of anatomical structures will be performed with the standard 2D method, in the remaining 50% with a 2D and 3D reconstruction. The assignment will take place through access to an online feature on the study website. Evaluations and statistical methods The statistical analysis will be carried out using parametric and nonparametric descriptive, inferential statistical methods, while the main outcome will be carried out using the analysis of variance (ANOVA) and covariance (ANCOVA) techniques. Ethical aspects. The study will be conducted in accordance with applicable current legislation. Approval by all relevant ethics committees will be required. Each patient will provide a written consent to participate in the study, after being properly informed.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
288
Before performing the surgery, patient performs a chest CT scan with contrast medium and standard two-dimensional (2D) reconstructions are performed to study the lesion, the anatomy of the bronchi and the pulmonary venous and arterial vessels.
Before performing the surgery, patient performs a chest CT scan with contrast medium and standard two-dimensional (2D) reconstructions plus a 3D reconstruction are performed to study the lesion, the anatomy of the bronchi and the pulmonary venous and arterial vessels.
Conversions from minimally invasive to thoracotomic procedure
Evaluation of conversions from minimally invasive to thoracotomic procedure
Time frame: Intraoperative
Margin- and disease-free resection
Margin- and disease-free resection
Time frame: 1 Month postoperative
Operating times
Evaluation of operating times
Time frame: Intraoperative
Intraoperative blood loss
Evaluation of intraoperative blood loss
Time frame: Intraoperative
Intraoperative major bleeding
Intraoperative major bleeding
Time frame: Intraoperative
Intraoperative air leaks and the use of sealants
Evaluation of intraoperative air leaks and the use of sealants
Time frame: Intraoperative
Postoperative air leaks
Evaluation of postoperative air leaks
Time frame: up to 2 weeks
Hospitalization times
Evaluation of hospitalization times
Time frame: up to 3 weeks
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