Multicenter segmentectomy in VR

VR-guided segmentectomies have shown a 50% change of surgical plan compared to 2D-CT planned segmentectomies. In this multicenter study, 100 patients will be included, coming from 6 to 7 different centers in The Netherlands, to determine the additional value of advanced imaging (based on 3D-VR and artificial intelligence) compared to conventional CT planning on the surgical strategy for lung segmentectomy. During 1 year, patients with early stage lung cancer, metastatic pulmonary lesions or benign pathology, suitable for segment resection based on multidisciplinary discussion, will be included. First, all centers will set up an operative plan based on 2D-CT (approach, which segments need to be resected etc). Meanwhile, researchers make the conventional CT VR-ready and redistribute the 3D-VR images over all participating centers. Then, all centers will make a new operative plan. Operating center is blinded to the results of other centers, but can adjust its surgical plan based on the 3D-VR images. Afterwards, perioperative outcomes and pathological outcomes will be collected.

Additional value of 3D-VR over 2D-CT will show that lung surgery will be in some cases more lung sparing or will result in better preoperative planning by having more information about important parameters (resection margin, anatomic variation) that will make lung resection surgery more safe en tumor specific will result in an oncological better radical resection.

The primary outcome: 3D-VR planning vs 2D-CT planning and its operative plan will be determined 1 to 2 weeks after patient inclusion and before surgery. The perioperative parameters will be collected 1 month after surgery (to include all complications that could have occurred in the 30 days after surgery).