腹腔镜外科杂志2025，Vol.30Issue(3)：179-184,191,7.DOI:10.13499/j.cnki.fqjwkzz.2025.03.179
CT重建模拟导航在胸腔镜肺叶切除术中的应用效果及学习曲线分析
Application effect and learning curve analysis of CT reconstruction simulated navigation in thoracoscopic lobectomy
摘要
Abstract
Objective:To explore the effect and learning curve of CT reconstruction simulated navigation in thoracoscopic lobectomy.Methods:A retrospective analysis was conducted on the clinical data of 118 lung cancer patients from Jan.2022 to Jan.2024.The patients were divided into a conventional group and a reconstruction group based on whether CT reconstruction simulation navigation was performed,with 59 cases in each group.The conventional group underwent thoracoscopic lobectomy according to the con-ventional protocol,while the reconstruction group used chest CT data to complete a three-dimensional reconstruction of the lungs and performed thoracoscopic lobectomy combined with intraoperative navigation.The surgical situation,postoperative lung function recovery,and incidence of complications were analyzed in both groups.At the same time,according to the order of surgical dates,the reconstruc-tion group was divided into four subgroups:Group A(1～15 cases from Jan.to Jun.2022),Group B(16～30 cases from Jul.to Dec.2022),Group C(31～45 cases from Jan.to Jun.2023),and Group D(46～59 cases from Jul.2023 to Jan.2024).The operation time of patients was analyzed,and the cumulative sum method was used to evaluate the learning curve of CT reconstruction simulation naviga-tion-assisted thoracoscopic lobectomy.Results:No significant difference was observed in the number of lymph node dissected between the two groups(P>0.05),The reconstruction group had shorter operation time,lower postoperative drainage during the first 3 days,intraoperative blood loss,and conversion to thoracotomy rate than the conventional group(P<0.05).On postoperative day 3,the first second forced expiratory volume,forced vital capacity,and maximum ventilation in both groups decreased compared to preoperative levels,but the reconstruction group was higher than the conventional group(P<0.05);three months after surgery,the levels increased compared to postoperative day 3,with no significant difference between the two groups.There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).The learning curve,constructed with operation time as the parameter,showed that the cubic curve had the highest goodness of fit(P<0.001,goodness of fit coefficient R2=0.710).The fitting curve was then plotted using the cumulative sum value fitting equation,and the goodness of fit of the cubic curve reached 0.984.The learning curve plateaued after 56 cases.Conclusions:The application of CT reconstruction simulation navigation in thoracoscopic lobectomy has shown good results,which is beneficial for reducing intraoperative bleeding and postoperative drainage,accelerating early recovery of postoperative lung function,and demonstrates a clear learning curve,which stabilizes after approximately 56 cases.关键词
肺叶切除术/胸腔镜检查/CT重建/学习曲线Key words
Pulmonary lobectomy/Thoracoscopy/CT reconstruction/Learning curve分类
临床医学引用本文复制引用
杨存,李广强,林颖..CT重建模拟导航在胸腔镜肺叶切除术中的应用效果及学习曲线分析[J].腹腔镜外科杂志,2025,30(3):179-184,191,7.基金项目
宁夏回族自治区卫生健康系统科研课题(2022-NWKY-095) （2022-NWKY-095）
