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中华普外科手术学杂志(电子版) ›› 2019, Vol. 13 ›› Issue (06) : 563 -566. doi: 10.3877/cma.j.issn.1674-3946.2019.06.008.

所属专题: 文献

论著

3D重建及打印技术在肝脏外科术前精准评估的作用研究
孙宏智1, 张波2, 李东伟2, 李海军2,()   
  1. 1. 232001 安徽淮南,安徽理工大学医学院
    2. 518001 深圳,深圳市罗湖区人民医院普外科
  • 收稿日期:2019-03-26 出版日期:2019-12-26
  • 通信作者: 李海军

The role of 3D reconstruction and printing technology in accurate preoperative evaluation of liver surgery

Hongzhi Sun1, Bo Zhang2, Dongwei Li2, Haijun Li2,()   

  1. 1. School of Medicine, Anhui University of Science and Technology, Anhui 232001, China
    2. Department of General Surgery, Luohu District People’s Hospital, Guangdong 518001, China
  • Received:2019-03-26 Published:2019-12-26
  • Corresponding author: Haijun Li
  • About author:
    Corresponding author: Li Haijun, Email:
  • Supported by:
    Shenzhen health and family planning system research project(NO.szxj2018030); National Natural Science Foundation of China(NO.81360328)
引用本文:

孙宏智, 张波, 李东伟, 李海军. 3D重建及打印技术在肝脏外科术前精准评估的作用研究[J/OL]. 中华普外科手术学杂志(电子版), 2019, 13(06): 563-566.

Hongzhi Sun, Bo Zhang, Dongwei Li, Haijun Li. The role of 3D reconstruction and printing technology in accurate preoperative evaluation of liver surgery[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(06): 563-566.

目的

评价3D重建及打印技术在肝脏外科术前精准评估的作用和意义。

方法

回顾性分析2016年1月至2019年1月间接受肝切除术患者80例。根据术前评估的方式不同,将患者分为术前3D重建及打印技术组(3D组,n=40)和未进行术前3D重建及打印技术(非3D组,n=40)两组。采用SPSS20.0统计软件分析,两组围术期各项指标以(±s)表示,独立t检验;并发症及术后死亡率比较采用χ2分析;预测的切除肝体积与实际切除体积进行相关性分析;P<0.05差异有统计学意义。

结果

3D组的中位手术时间比非3D组短36 min(P=0.048)。两组其他结果无显著性差异。亚组分析显示,重复肝切除和节段切除的手术时间3D组明显短于非3D组(P=0.03)。预测的肝脏体积与实际切除肝脏重量呈显著正相关(r=0.80,P<0.001)。

结论

术前3D重建及打印技术可以缩短手术时间,特别是重复肝切除和节段切除术。

Objective

To evaluate the role and significance of 3D reconstruction and printing technology in accurate preoperative evaluation of liver surgery.

Methods

Clinical data of 80 patients underwent hepatectomy, from January 2016 to January 2019, were analyzed retrospectively. According to the different preoperative evaluation, patients were divided into preoperative 3D reconstruction and printing technology group (3D group, n=40) and non-preoperative 3D reconstruction and printing technology group (non-3D group, n=40). Statistical analysis were performed by using SPSS20.0 software. Measurement data such as perioperative indicators were expressed as mean±standard deviation and were examined by independent t test. Count data such as complication rate and mortality were described by (n, %) and were examined by chi square test. The correlation between predicted resected liver volume and actual resected liver volume were also analyzed. A P value of <0.05 was considered as statistically significant.

Results

The median operation time of 36 min in the 3D group was shorter than that in non-3D group (P=0.048). There were no significant differences in other outcomes between two groups. Subgroup analysis showed that the operation time in 3D group was significantly shorter than that in non-3D group (P=0.03). There was a significant positive correlation between the predicted liver volume and the actual liver weight (r=0.80, P<0.001).

Conclusion

3D reconstruction and printing technology could shorten the operation time, especially repeated hepatectomy and segmental resection.

表1 80例接受肝脏切除患者3D重建与否两组患者基本资料比较(例)
表2 80例接受肝脏切除患者3D重建与否两组患者手术时间比较[(±s), min]
表3 80例接受肝脏切除患者3D重建与否两组患者术中和术后并发症指标比较[(±s),例]
图1 患者术前CT影像:显示肝脏巨大肿瘤。
图2 患者术前3D成像:显示肿瘤在肝脏中的位置,以及与肝脏血管的空间关系。
图3 患者术前3D成像:显示肝脏肿瘤与周围血管的空间关系。
图4 术前3D模型:显示肿瘤的位置与肝脏的三维立体形状和解剖特点,尤其是显露进出肝门的动静脉的走行。
图5 肝切除术后术区照片:由于3D模型的使用,创口出血较少,肿瘤切除完整。
图6 切除的肝脏肿物的标本:由于3D模型的使用,肿瘤切除非常完整,肿瘤周围正常肝组织很少。
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