{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:23:18Z","timestamp":1787289798911,"version":"build-2736575974"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100031928","name":"Affiliated Hospital of Guizhou Medical University","doi-asserted-by":"publisher","award":["\u5409\u83f2\u5e03\u65af\u57fa-2025-02\uff0cJ-2025-02, Gyfybsky-2021-7\uff0cJ-2021-7"],"award-info":[{"award-number":["\u5409\u83f2\u5e03\u65af\u57fa-2025-02\uff0cJ-2025-02, Gyfybsky-2021-7\uff0cJ-2021-7"]}],"id":[{"id":"10.13039\/100031928","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anatomical segmentectomy requires precise identification of the segmental bronchi and vessels; however, conventional two-dimensional (2D) CT provides limited visualisation of their three-dimensional (3D) anatomical relationships and variations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective randomised controlled trial, patients with early-stage non-small cell lung cancer (NSCLC) who were scheduled to undergo uniportal thoracoscopic anatomical segmentectomy were assigned to either the 2D CT group or the 3D reconstruction group. The trial was registered with the Chinese Clinical Trial Registry before patient enrolment (ChiCTR2500104962; registered 26 June 2025). The primary outcome was key-phase operative time, defined as the interval from the start of segmental hilar dissection to completion of segmentectomy. Total operative time, defined as the interval from skin incision to closure, was assessed as an additional time-based outcome. Secondary outcomes included intraoperative unexpected events, attainment of adequate pathological margins, and surgeon-reported experience. Prespecified subgroup analyses were conducted according to surgeon seniority and segmentectomy complexity. Surgeon-reported experience was assessed using structured questionnaires.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 144 patients were included. Compared with the 2D CT group, the 3D group demonstrated markedly reduced key-phase operative time (75.78 \u00b1 24.44 min vs 95.74 \u00b1 31.43, P &amp;lt; 0.001), fewer intraoperative unexpected events (6.9% vs 30.6%, P\u00a0=\u00a00.001), and a higher rate of achieving safe surgical margins (84.7% vs 66.7%, P\u00a0=\u00a00.016). No statistically significant differences were observed in total operative time, postoperative complications, or other perioperative outcomes between the two groups (P &amp;gt; 0.05). In contrast, surgeons in the 3D group reported superior preoperative anatomical visualization, enhanced intraoperative confidence, and reduced perceived stress levels (all P &amp;lt; 0.001). Notably, the reduction in key-phase operative time was more prominent among surgeons with less clinical experience (P\u00a0=\u00a00.018).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative 3D reconstruction shortened key-phase operative time, reduced intraoperative unexpected events, improved pathological margin attainment, and was associated with more favourable surgeon-reported experience.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1887152","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:23:01Z","timestamp":1787286181000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of patient-specific three-dimensional reconstruction on surgical planning and perioperative outcomes in early-stage lung cancer: a randomised clinical trial"],"prefix":"10.3389","volume":"16","author":[{"given":"Li Hang","family":"Liao","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhang Yong","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin Lian","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming Hai","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao Jun","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02333-3","article-title":"Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802\/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial","volume":"399","author":"Saji","year":"2022","journal-title":"Lancet (Lond Engl)"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2212083","article-title":"Lobar or sublobar resection for peripheral stage IA non\u2013small-cell lung cancer","volume":"388","author":"Altorki","year":"2023","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.14443","article-title":"Progress in three-dimensional computed tomography reconstruction in anatomic pulmonary segmentectomy","volume":"13","author":"Wu","year":"2022","journal-title":"Thorac Cancer"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.5090\/jcs.21.058","article-title":"Video-assisted thoracic surgery segmentectomy","volume":"54","author":"Kim","year":"2021","journal-title":"J Chest Surg"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-016-0686-4","article-title":"Analysis of the variation pattern in right upper pulmonary veins and establishment of simplified vein models for anatomical segmentectomy","volume":"64","author":"Shimizu","year":"2016","journal-title":"Gen Thorac Cardiovasc Surg"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(95)00537-u","article-title":"Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung cancer study group","volume":"60","author":"Ginsberg","year":"1995","journal-title":"Ann Thorac Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/j.jtcvs.2020.09.146","article-title":"A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer","volume":"163","author":"Suzuki","year":"2022","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(23)00041-3","article-title":"Segmentectomy for ground-glass-dominant lung cancer with a tumour diameter of 3 cm or less including ground-glass opacity (JCOG1211): a multicentre, single-arm, confirmatory, phase 3 trial","volume":"11","author":"Aokage","year":"2023","journal-title":"Lancet Respir Med"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.70159","article-title":"Advances in the application of three\u2010dimensional reconstruction in thoracic surgery: a comprehensive review","volume":"16","author":"Lin","year":"2025","journal-title":"Thorac Cancer"},{"key":"B10","doi-asserted-by":"publisher","first-page":"4086","DOI":"10.1038\/s41467-025-59200-8","article-title":"Artificial intelligence driven 3D reconstruction for enhanced lung surgery planning","volume":"16","author":"Chen","year":"2025","journal-title":"Nat Commun"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr.2019.11.27","article-title":"Three-dimensional printing in the preoperative planning of thoracoscopic pulmonary segmentectomy","volume":"8","author":"Liu","year":"2019","journal-title":"Transl Lung Cancer Res"},{"key":"B12","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.ijsu.2017.01.079","article-title":"Three-dimensional image reconstruction with free open-source OsiriX software in video-assisted thoracoscopic lobectomy and segmentectomy","volume":"39","author":"Yao","year":"2017","journal-title":"Int J Surg"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1007\/s13304-024-01965-6","article-title":"The advantages of preoperative 3D reconstruction over 2D-CT in thoracoscopic segmentectomy","volume":"76","author":"He","year":"2024","journal-title":"Updates Surg"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.968199","article-title":"Application of three-dimensional (3D) reconstruction in the treatment of video-assisted thoracoscopic complex segmentectomy of the lower lung lobe: a retrospective study","volume":"9","author":"X","year":"2022","journal-title":"Front Surg"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.10.126","article-title":"Preoperative 3-dimensional computed tomography lung simulation before video-assisted thoracoscopic anatomic segmentectomy for ground glass opacity in lung","volume":"10","author":"Xue","year":"2018","journal-title":"J Thorac Dis"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr-20-571","article-title":"Three-dimensional reconstruction\/personalized three-dimensional printed model for thoracoscopic anatomical partial-lobectomy in stage I lung cancer: a retrospective study","volume":"9","author":"Qiu","year":"2020","journal-title":"Transl Lung Cancer Res"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezae250","article-title":"Three-dimensional reconstruction computed tomography in thoracoscopic segmentectomy: a randomized controlled trial","volume":"66","author":"Chen","year":"2024","journal-title":"Eur J Cardiothorac Surg"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2015.06.051","article-title":"Preoperative (3-dimensional) computed tomography lung reconstruction before anatomic segmentectomy or lobectomy for stage I non-small cell lung cancer","volume":"150","author":"Chan","year":"2015","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.08.027","article-title":"Anatomic thoracoscopic pulmonary segmentectomy under 3-dimensional multidetector computed tomography simulation: a report of 52 consecutive cases","volume":"141","author":"Oizumi","year":"2011","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1998","DOI":"10.1001\/jama.2025.4347","article-title":"CONSORT 2025 statement: updated guideline for reporting randomized trials","volume":"333","author":"Hopewell","year":"2025","journal-title":"JAMA"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16132343","article-title":"Uniportal video-assisted thoracoscopic segmentectomy for early-stage non-small cell lung cancer: overview, indications, and techniques","volume":"16","author":"Watanabe","year":"2024","journal-title":"Cancers"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr-24-595","article-title":"Three-dimensional reconstruction for determining positional indications of pulmonary segmentectomy\/subsegmentectomy for ground glass opacity-dominant clinical T1a-bN0 non-small cell lung cancer","volume":"13","author":"Bian","year":"2024","journal-title":"Transl Lung Cancer Res"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2204.0023","article-title":"Non-small cell lung cancer, version 4.2024, NCCN clinical practice guidelines in oncology","volume":"22","author":"Riely","year":"2024","journal-title":"J Natl Compr Cancer Netw JNCCN"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezaf283","article-title":"Three-dimensional reconstruction and virtual simulation of patient-specific anatomy for procedural planning in thoracoscopic segmentectomy: a systematic review and meta-analysis","volume":"67","author":"He","year":"2025","journal-title":"Eur J Cardiothorac Surg"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.941582","article-title":"Three-dimensional computed tomography reconstruction in\u2002video-assisted thoracoscopic segmentectomy (DRIVATS): a\u2002prospective, multicenter randomized controlled trial","volume":"9","author":"Niu","year":"2022","journal-title":"Front Surg"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-2025-1836","article-title":"3DCT reconstruction-does 3DCT improve anatomical lung resection?-a narrative review of the literature","volume":"17","author":"Baboolal","year":"2025","journal-title":"J Thorac Dis"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr-24-134","article-title":"Evaluating three-dimensional lung reconstructions for thoracoscopic lung resections using open-source software: a pilot study","volume":"13","author":"Laven","year":"2024","journal-title":"Transl Lung Cancer Res"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2024.04.018","article-title":"What is an adequate margin during sublobar resection of \u22643 cm N0 subsolid lung adenocarcinomas","volume":"118","author":"Kamtam","year":"2024","journal-title":"Ann Thorac Surg"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivab328","article-title":"Does surgical margin affect recurrence and survival after sublobar pulmonary resection for lung cancer","volume":"34","author":"Liu","year":"2022","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-019-05276-5","article-title":"The effect of resection margin distance and invasive component size on recurrence after sublobar resection in patients with small (\u22642 m) lung adenocarcinoma","volume":"44","author":"Moon","year":"2020","journal-title":"World J Surg"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.11.037","article-title":"Superselective segmentectomy for deep and small pulmonary nodules under the guidance of three-dimensional reconstructed computed tomographic angiography","volume":"89","author":"Nakamoto","year":"2010","journal-title":"Ann Thorac Surg"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16122181","article-title":"Quantification of resection margin following sublobar resection in lung cancer patients through pre- and post-operative CT image comparison: utilizing a CT-based 3D reconstruction algorithm","volume":"16","author":"Lin","year":"2024","journal-title":"Cancers"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2013.11.056","article-title":"Relationship between margin distance and local recurrence among patients undergoing wedge resection for small (\u22642 cm) non-small cell lung cancer","volume":"147","author":"Mohiuddin","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0000000000000486","article-title":"Tumor spread through air spaces is an important pattern of invasion and impacts the frequency and location of recurrences after limited resection for small stage I lung adenocarcinomas","volume":"10","author":"Kadota","year":"2015","journal-title":"J Thorac Oncol Off Publ Int Assoc Study Lung Cancer"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-23-711","article-title":"Impact of surgical margin after sublobar resection of lung cancer: a narrative review","volume":"15","author":"Nagano","year":"2023","journal-title":"J Thorac Dis"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.01.061","article-title":"Video-assisted thoracoscopic surgery segmentectomy: a safe and effective procedure","volume":"89","author":"Leshnower","year":"2010","journal-title":"Ann Thorac Surg"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-21-1578","article-title":"Three-dimensional reconstruction facilitates thoracoscopic anatomical partial lobectomy by an inexperienced surgeon: a single-institution retrospective review","volume":"13","author":"Liu","year":"2021","journal-title":"J Thorac Dis"},{"key":"B38","doi-asserted-by":"publisher","first-page":"194","DOI":"10.21037\/tlcr-24-849","article-title":"The utility and feasibility of three-dimensional reconstruction in surgical planning for multiple pulmonary nodules: a prospective self-controlled study","volume":"14","author":"Li","year":"2025","journal-title":"Transl Lung Cancer Res"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-22-555","article-title":"Uniportal thoracoscopic pulmonary segmentectomy provides good perioperative results and early postoperative recovery","volume":"14","author":"Numajiri","year":"2022","journal-title":"J Thorac Dis"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1887152\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:23:02Z","timestamp":1787286182000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1887152\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":39,"alternative-id":["10.3389\/fonc.2026.1887152"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1887152","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"article-number":"1887152"}}