The Guidance of Thin Cross- Section of CT in Anatomic Segmentectomy

Study Overview
=================
Brief Summary
-----------------
Three-dimensional (3D) simulation of pulmonary vessels and the space between the lesion and adjacent tissues is regarded improving the safety and accuracy of video-assisted thoracoscopic surgery (VATS) for segmentectomy for ground glass opacity (GGO) in lung. However, not every thoracic surgeon can handle the technique, in addition, the 3D reconstruction originate from the thin CT scan. Actually, the investigators found that, the reading and comprehension of the thin cross- section of CT can guide the accurate anatomic segmentectomy in most situations. The investigators designed a retrospective study to compare the reading of thin cross- section of CT with 3D reconstruction or without 3D reconstruction during the guidance of anatomic segmentectomy.

Official Title
-----------------
The Guidance of Thin Cross- Section of CT in Anatomic Segmentectomy With or Without 3-dimensional Computed Tomography Lung Simulation

Conditions
-----------------
Thin Cross- Section of CT, Segmentectomy, Video- Assisted Thoracoscopic Surgery, Three-dimensional-computed Tomography (3D-CT)

Intervention / Treatment
-----------------
* Other: Cross- Section of CT Guided Anatomic Segmentectomy
* Other: 3D simulation Guided Anatomic Segmentectomy


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Selection criteria for VATS segmentectomy in the present study were as follows: (I) patients with single peripheral GGO lesion considered suspicious for malignancy; (II) the lesion <2 cm in diameter and with at least one of the followings: (i) pure adenocarcinoma in situ (AIS) histology; (ii) nodule has ≥50% ground-glass appearance on high resolution CT; (iii) radiologic surveillance conforms a long doubling time (≥400 days). Exclusion Criteria: (I) patients with insufficient cardiopulmonary function; (II) other contraindication for segmentectomy.

Ages Eligible for Study
-----------------
Minimum Age: 25 Years
Maximum Age: 85 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: group of thin cross- section of CT<br>Anatomic Segmentectomy with the Guidance of Thin Cross- Section of CT | Other: Cross- Section of CT Guided Anatomic Segmentectomy<br>* The anatomic segmentectomy is base on the reading and comprehension of Cross- Section of CT.<br>|
| Active Comparator: group of thin 3D simulation<br>Anatomic Segmentectomy with the Guidance of 3D simulation | Other: 3D simulation Guided Anatomic Segmentectomy<br>* The anatomic segmentectomy is base on the overview of 3D simulation of pulmonary structure.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| planning time (minutes) | the planning time for anatomic segmentectomy before surgery, including the time- cost of the decision making and the planning time for surgery | from the first time of thin cross- section of CT is presented to the end of surgery, within 7 days | 
| time before surgery (days) | days before surgery after being hospitalized | from the day of being hospitalized to the day of surgery, within 5 days | 
| operation time (minutes) | the duration of the operation time | from beginning to the end of surgery, up to 180 minutes | 
| confirmation time during surgery （number） | review time of the 3D reconstruction or the thin cross- section of CT during surgery | Intraoperative | 
| air leakage after surgery (days) | the days of air leakage after surgery | within 7 days after surgery | 
| the incidence of pneumonia （percentage） | the incidence of pneumonia after surgery | within 7 days after surgery | 
| the incidence of atelectasis （percentage） | the incidence of atelectasis after surgery | within 7 days after surgery | 
| Intraoperative bleeding (ml) | bleeding during anatomic segmentectomy, through the operation, an average of 100 ml | Intraoperative | 
| Chest tube duration (days) | Chest tube duration after surgery | within 7 days after surgery | 
| Postoperative hospital stay (days) | hospital stay after surgery | within 7 days after surgery |