Abstract
Background and Objective: Segmentectomy is recognized as a viable alternative to lobectomy for select patients with small peripheral non-small cell lung cancer (NSCLC). However, the complexity of pulmonary segmental anatomy poses technical challenges. Advances in three-dimensional (3D) computed tomography (CT) reconstruction have shown promise in improving preoperative planning and intraoperative precision. The objective of this review is to evaluate the current role of 3D CT reconstruction in preoperative planning for lung segmentectomy, focusing on its clinical outcomes, educational utility, and potential costeffectiveness. Methods: This review explores the clinical utility of 3D CT reconstruction in thoracic surgery, with a focus on segmentectomy. We analyze current literature (PubMed, Embase, Cochrane Library, and Scopus) in English on surgical outcomes, educational applications, and economic impact between January 1, 2005, and January 31, 2025, and share our institution's recent experience incorporating 3D reconstruction into preoperative planning. Key Content and Findings: Retrospective studies suggest that 3D reconstruction enhances anatomic visualization, reduces operative time and blood loss, and may decrease conversion rates to thoracotomy. Our experience aligns with these findings: since implementing 3D planning software, we have observed more accurate identification of broncho-vascular structures and improved correlation with intraoperative anatomy. This has enhanced surgical decision-making and oncologic margin assessment. Additionally, 3D models are effective educational tools for surgical trainees. Conclusions: 3D CT reconstruction represents a valuable innovation in thoracic surgery, facilitating safer and more effective segmentectomy. While preliminary outcomes are encouraging, further studies are needed to validate its impact on long-term patient outcomes and cost-effectiveness.