ObjectiveTo explore the clinical value of three-dimensional computed tomography bronchography and angiography (3D-CTBA) combined with 3D printing technology applying for preoperative planning and intraoperative navigation assistance on non-small cell lung cancer (NSCLC) in early stage. MethodsEighty-one NSCLC patients in early stage undergoing thoracoscopic anatomic segmentectomy were enrolled and randomly assigned to 3D-CTBA combined with 3D printing group (3D printing group for short, 30 cases), 3D-CTBA group (29 cases), and thin-layer CT scan group (22 cases). Basic states of the surgery, complexity of the surgery, perioperative related indices, and the prevalence of postoperative complications were recorded and compared between the three groups. Results(1) The surgery for three groups was successfully completed, without transferring to open surgery or surgical methods changes. Preoperative localization: preoperative Hookwire localization was employed to 11 cases in the thin-layer CT scan group; moreover, three-dimensional non-invasive localization was used to the 3D-CTBA and the 3D printing groups, with the successful rate of 100.0% (59/59). The accordance rate between preoperative planning and intraoperative facts was 96.6% (28/29) in the 3D-CTBA group, whereas the aforesaid rate of the 3D printing group was 100.0% (30/30). (2) There were statistically significant differences in surgical duration, intraoperative bleeding volume, distance from incision edge, postoperative hospital stays between the three groups (all P＜0.05), and the difference of pairwise comparison was statistically significant (all P＜0.017). The 4 aforesaid indicators were hierarchically compared according to the difficulties of the surgery, and the differences between various difficulties of the three groups were statistically significant (all P＜0.05); moreover, pairwise comparison revealed that the 3D printing group yielded superior levels of indicators in various difficulties, including surgical duration, intraoperative bleeding volume, distance from incision edge, and postoperative hospital stays, to compared with the thin-layer CT scan group (all P＜0.017); furthermore, the 3D printing group obtained superior indicators levels in the complex surgery including surgical duration, intraoperative bleeding volume, distance from incision edge, and superior levels in various difficulties of postoperative hospital stays to compared with the 3D-CTBA group (all P＜0.017); in addition, compared to the thin-layer CT scan group, the 3D-CTBA group expressed superior levels of surgical duration in terms of general and moderate surgical difficulties, and superior level of intraoperative bleeding volume in moderate surgical difficulty (all P＜0.017). There were no statistically significant differences in nodal diameter, postoperative drainage volume, number of lymph node removal, and postoperative tube indwelling time between the three groups (all P＞0.05). (3) The difference of the incidence of postoperative complications was statistically significant (P＜0.05), and the pairwise comparison demonstrated that the 3D printing group exhibited lower incidence of postoperative complications as compared with the thin-layer CT scan group (all P＜0.017). ConclusionThe thoracoscopic anatomic segmentectomy will be safer, more accurate and convenient, and may promote rapid recovery of patients via individually employing 3D-CTBA in planning navigation combined with 3D printing modelling assistance for NSCLC in early stage. The aforementioned technology has more advantages in moderate and high difficulties of lung segmentectomy, and thus it is worthy of clinical promotion and application.

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