Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 13:9:941582.
doi: 10.3389/fsurg.2022.941582. eCollection 2022.

Three-dimensional computed tomography reconstruction in video-assisted thoracoscopic segmentectomy (DRIVATS): A prospective, multicenter randomized controlled trial

Zhenyi Niu  1 , Kai Chen  1 , Runsen Jin  1 , Bin Zheng  2 , Xian Gong  2 , Qiang Nie  3 , Benyuan Jiang  3 , Wenzhao Zhong  3 , Chun Chen  2 , Hecheng Li  1
Affiliations

Three-dimensional computed tomography reconstruction in video-assisted thoracoscopic segmentectomy (DRIVATS): A prospective, multicenter randomized controlled trial

Zhenyi Niu et al. Front Surg. .

Abstract

Objective: Anatomical segmentectomy has been proven to be a viable surgical treatment for small-size peripheral lung nodules. Three-dimensional (3D) reconstruction computed tomography (CT) has been proposed as an effective approach to overcome the challenges of encountering pulmonary anatomical variations when performing segmentectomy. Therefore, to further investigate the usefulness of preoperative 3D reconstruction CT in segmentectomy, we will conduct this prospective, multicenter randomized controlled DRIVATS study to compare the use of 3D reconstruction CT with standard chest CT in video-assisted segmentectomy (ClinicalTrials.gov ID: NCT04004494).

Methods: This study began in July 2019 and a total of 190 patients will be accrued from three clinical centers within 4 years. The main inclusion criteria are patients with a single peripheral nodule 0.8-2 cm with at least one of the following requirements: (i) histology of adenocarcinoma in situ; (ii) nodule has ≥50% ground-glass appearance on CT; (iii) radiologic surveillance confirms a long doubling time (≥400 days). Surgical procedures include segmental resection of the lesion and mediastinal lymph node sampling (subsegmental resection or combined subsegmental resection will not be included in this study). The primary endpoint is operative time. The secondary endpoints include incidence of change of surgical plan, intraoperative blood loss, conversion rate, operative accident event, incidence of postoperative complications, postoperative hospital stay, length of hospitalization, duration of chest tube placement, postoperative 30-day mortality, dissection of lymph nodes, overall survival, disease-free survival, preoperative lung function, and postoperative lung function.

Discussion: This multicenter DRIVATS study aims to verify the usefulness of preoperative 3D reconstruction CT compared with standard chest CT in segmentectomy. If successfully completed, this multicenter prospective study will provide a higher level of evidence for the use of 3D reconstruction CT in segmentectomy.

Keywords: 3D reconstruction CT; multicenter randomized controlled trial; pulmonary nodules; segmentectomy; video-assisted thoracoscopic.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A 47-year-old male patient was admitted into our hospital after his chest CT scan revealed a GGO (A, red circle) in his right lung in his routine physical examination. The preoperative 3D reconstruction CT located the nodule in the peripheral region of the apical segment of the right upper lobe, measuring 7.6 mm × 7.3 mm × 7.8 mm in size (B, black arrow). This man received an apical segmentectomy and the pathology of this nodule was AIS. AIS, adenocarcinoma in situ; CT, computed tomography; GGO, ground-glass opacity; 3D, three-dimensional.
Figure 2
Figure 2
Trial design and flow chart of the DRIVATS study. *Details of the secondary endpoints are described in Materials and methods. CT, computed tomography; 3D, three-dimensional.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. (2022) 72(1):7–33. 10.3322/caac.21708 - DOI - PubMed
    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. (2021) 71(3):209–49. 10.3322/caac.21660 - DOI - PubMed
    1. Herbst RS, Morgensztern D, Boshoff C. The biology and management of non-small cell lung cancer. Nature. (2018) 553(7689):446–54. 10.1038/nature25183 - DOI - PubMed
    1. Kudo Y, Matsubayashi J, Saji H, Akata S, Shimada Y, Kato Y, et al. Association between high-resolution computed tomography findings and the IASLC/ATS/ERS classification of small lung adenocarcinomas in Japanese patients. Lung Cancer. (2015) 90(1):47–54. 10.1016/j.lungcan.2015.07.007 - DOI - PubMed
    1. Suzuki K, Watanabe SI, Wakabayashi M, Saji H, Aokage K, Moriya Y, et al. A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer. J Thorac Cardiovasc Surg. (2022) 163(1):289.e282–301.e282. 10.1016/j.jtcvs.2020.09.146 - DOI - PubMed

Associated data