To investigate the clinical value of three-dimensional computed tomography bronchography and angiography combined with Hookwire localization in thoracoscopic segmentectomy.

The clinical data of 48 patients undergoing thoracoscopic segmentectomy from Dec. 2018 to Feb. 2020 in our department were retrospectively analyzed in this study. All the patients underwent 3D-CTBA using the Mimics software to show the anatomy of pulmonary segments, in order to make clear the accurate location of the nodule and explicit the courses and variations of bronchi and blood vessels. So that the personalized operation scheme including the target bronchi and blood vessels to be amputated can be made before operation. All patients were treated with Hookwire localization needle under CT guidance and then thoracoscopic segmentectomy were performed.

None of Hookwires dislodged or displaced during the transport to the operation room and the surgeries were successfully completed in 48 patients without a transfer to open procedure. The mean procedure time for the CT-guided Hookwire localization was (19.71±3.94)min, 5 patients of them had the pneumothorax. The mean operation time was (109.67±17.21)min, the mean intraoperative blood loss was (65.42±21.62)ml, mean thoracic tube drainage time was (4.13±1.26)d and postoperative thoracic drainage was (548.33±228.78)ml. The average postoperative hospitalization was (6.25±1.48) d. There were no serious complications or death during the perioperative period.

The application of preoperative 3D-CTBA combined with CT-guided Hookwire localization is helpful for safe and accurate anatomical thoracoscopic segmentectomy, which has productive clinical application value.

To discuss the efficacy of laparoscopic deep infiltrating endometriosis surgery.

Clinical data of 225 cases who underwent laparoscopic deep infiltrating endometriosis surgery in Chinese PLA General Hospital between Jan. 2008 and Jul. 2018 were analyzed retrospectively. Clinical features, perioperative outcomes, recurrence and natural conception rate were analyzed.

Among the 225 cases, 178 cases(79.1%) had dysmenorrhea, 33 cases (14.7%)had dyspareunia, 1 case(0.4%) had hematochezia, 2 cases (0.9%)had hematuresis, 8 cases (3.6%)had constipation, 6 cases (2.7%)had diarrhea, 42 cases (18.7%)had no symptom. Average blood loss was(94.4±191.6) ml, average operative time was (85.5±51.0) min, average hospital stay was (8.4±4.9) d. Complication rate was 1.3%. Follow up period ranged from 1-144 months(Median follow-up time 57 months ), 24 months recurrence rate was 8.4%, 60 months recurrence rate was 16.4%, overall recurrence rate was 19.6%. Natural conception rate was 67.5%.

Laparoscopic deep infiltrating endometriosis surgery is safe and effective for deep infiltrating endometriosis.