Objective:

To assess the clinical utility of preoperative 3D CT reconstruction during uniportal thoracoscopic anatomical segmentectomy for early-stage non-small cell lung cancer (NSCLC).

Approach:

• Outcomes Measured: Key-phase operative time, total operative time, unexpected intraoperative events, achievement of adequate pathological margins, and surgeon-reported experience evaluated through structured questionnaires.

Key Findings:

• 3D reconstruction group had a significantly shorter key-phase operative time (75.78 min vs 95.74 min, P < 0.001).
• Fewer unexpected intraoperative events in the 3D group (6.9% vs 30.6%, P = 0.001).
• Higher likelihood of achieving safe surgical margins in the 3D group (84.7% vs 66.7%, P = 0.016).
• Surgeons reported better preoperative anatomical visualization and greater intraoperative confidence with 3D reconstruction (P < 0.001).

Interpretation:

The findings suggest that the use of 3D CT reconstruction in surgical planning for early-stage NSCLC significantly enhances the surgical process. The reduction in key-phase operative time and unexpected intraoperative events indicates that surgeons are better prepared and more confident when utilizing this technology. Additionally, the improved rates of achieving adequate surgical margins highlight the potential for better oncological outcomes.

Limitations:

• Total operative time and postoperative complications did not differ significantly between groups (P > 0.05).
• The study was limited to a single center and a specific patient population.

Conclusion:

Incorporating customized 3D reconstruction into the surgical strategy for early-stage lung cancer can lead to improved operative efficiency and potentially better surgical outcomes, underscoring the importance of advanced imaging techniques in modern thoracic surgery. Further studies are warranted to validate these findings across diverse populations and settings.