Three-Dimensional Reconstruction and Virtual Simulation of Patient-Specific Anatomy for Procedural Planning in Thoracoscopic Segmentectomy: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis evaluated whether three-dimensional (3D) reconstruction and virtual simulation improve outcomes in thoracoscopic segmentectomy. Ten studies (n=1,424; 772 3D vs 652 non-3D) were included. Overall, 3D-assisted planning significantly reduced inadequate surgical margins (OR 0.09, p=0.006) and postoperative complications (OR 0.53, p<0.001). In subgroup analysis, complex segmentectomies performed with 3D planning had shorter operative times (mean difference–10.9 minutes) and less blood loss (–5.4 ml). No differences were found in lymph node yield, chest tube duration, total drainage, or hospital stay. While benefits were most pronounced in anatomically complex resections, heterogeneity across studies was high, and most studies were retrospective, limiting generalizability. The authors conclude that patient-specific 3D reconstruction enhances surgical precision and safety by lowering complication and margin failure rates, and in complex cases, it reduces operative burden, supporting its adoption as a tool for procedural planning in minimally invasive segmentectomy.