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Three dimensional computed tomography for preoperative assessment of the pulmonary artery in patients undergoing endoscopic lobectomy or segmentectomy.

Three dimensional computed tomography for preoperative assessment of the pulmonary artery in patients undergoing endoscopic lobectomy or segmentectomy.
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Ojanguren A, Recuero JL, Pardina M, Milla L, Santamaría M,


Ojanguren A, Recuero JL, Pardina M, Milla L, Santamaría M, (click to view)

Ojanguren A, Recuero JL, Pardina M, Milla L, Santamaría M,

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Cirugia espanola 2017 02 14() pii S0009-739X(17)30020-9
Abstract
BACKGROUND
The interest for endoscopic pulmonary anatomic resections has grown exponentially during the last decade. During thoracoscopic procedures surgeons cannot rely on digital handling and operative field is viewed on a two-dimensional video monitor, thus frequently encountering anatomical difficulties. The hypothesis is that foreknowledge of the anatomy of each patient would greatly contribute to the safety and accuracy of the operation. The aim of the study was to evaluate the effectiveness of 3dimensional multidetector computed tomography (3D-MDCT) software to identify the pulmonary artery branching pattern during the preoperative study of endoscopic lobectomies and segmentectomies.

METHODS
Descriptive prospective study of 25consecutive patients scheduled from November 2015 to July 2016 in a tertiary referral academic hospital for VATS lobectomy or segmentectomy and evaluated about branching pattern of the pulmonary artery with preoperative 16-row 3D-MDCT angiography. Intraoperative findings of the pulmonary branching pattern were compared with the preoperative 3D-MDCT angiography images.

RESULTS
According to the intraoperative findings, 67 out of 68 (98%) of pulmonary artery branches were well defined in the 3D-MDCT angiography images. There was a unique 2mm undetected branch. No conversion to open thoracotomy was needed because of intraoperative bleending.

CONCLUSION
3D-MDCT angiography imaging is useful for preoperative identification of the pulmonary artery branching pattern.

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