Application value of blood flow topology liver segmentation and Couinaud liver segmentation in preoperative evaluation and surgical planning of primary liver cancer

doi:10.3877/cma.j.issn.1674-3946.2022.04.020

Abstract

Abstract:

Objective

To evaluate the value of blood flow topological liver segmentation and Couinaud liver segmentation in preoperative evaluation and surgical planning of primary liver cancer.

Methods

A total of 100 patients with primary liver cancer admitted from January 2018 to June 2020 were prospectively enrolled and divided into Couinaud group（Couinaud liver segmentation for preoperative evaluation and surgical planning）and blood flow topology group（blood flow topology liver segmentation for preoperative evaluation and surgical planning）according to random number table method，with 50 patients in each group. SPSS 22.0 was used for data analysis. Perioperative related indexes were expressed by（

x ˉ

±s），and independent t test was performed between groups. Postoperative indicators and other measurement data were conted by χ² test. Kaplan-Meier parallel Log-Rank test was used for survival analysis. P<0.05 indicated statistical difference.

Results

The operative time，intraoperative blood loss，intraoperative blood transfusion and postoperative hospital stay in the blood flow topology group were better than those in the Couinaud group（P<0.05）. The simulated liver volume and actual resected liver volume in the hematological topology group were significantly lower than those in the Couinaud group（P<0.05）. Compared with the simulated resected liver volume，actual hepatectomy volume decreased more significantly in Couinaud group（P<0.05）. There was no significant difference in the incidence of postoperative complications between the two groups（20.0%vs.12.0%），P>0.05.Kaplan-Meier analysis showed that there was no significant difference in cumulative overall survival and disease-free survival between 2 groups（P>0.05）.

Conclusion

Compared with couimud liver segmentation，blood flow topology liver segmentation can more accurately predict the volume and guide accurate operation during operation. It can not only shorten the operation time and reduce injury，but also benefit the postoperative recovery of patients with good prognosis.

Key words: Primary liver cancer, Hepatectomy, Liver segmentation

Yiqi Dong, Yaobing Luo, Tao Liu, Lan Zhang, Ming Yang. Application value of blood flow topology liver segmentation and Couinaud liver segmentation in preoperative evaluation and surgical planning of primary liver cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(04): 423-426.

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Figures/Tables 4

References 14

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组别	例	性别	年龄(岁)		BMI(kg/m²)	切除范围^a
组别	例	男/女	年龄(岁)		BMI(kg/m²)	A/B/C
Couinaud组	50	35/15	52.1±8.1		22.1±2.1	18/21/11
血流拓扑学组	50	38/12	51.4±9.3		21.6±2.5	16/26/8
t/χ²/Z		0.457	0.875		1.083	1.123
P		0.499	0.192		0.141	0.570
组别	例	肿瘤直径 (cm)	合并肝炎情况		肝功能分级	分化程度
组别	例	肿瘤直径 (cm)	有	无	A/B	高/中/低
Couinaud组	50	7.1±2.8	40	10	44/6	4/38/8
血流拓扑学组	50	7.4±2.6	38	12	46/4	3/41/6
t/χ²/Z		0.555	0.233		0.444	-0.243
P		0.290	0.629		0.505	0.808

组别	例	性别	年龄(岁)		BMI(kg/m²)	切除范围^a
组别	例	男/女	年龄(岁)		BMI(kg/m²)	A/B/C
Couinaud组	50	35/15	52.1±8.1		22.1±2.1	18/21/11
血流拓扑学组	50	38/12	51.4±9.3		21.6±2.5	16/26/8
t/χ²/Z		0.457	0.875		1.083	1.123
P		0.499	0.192		0.141	0.570
组别	例	肿瘤直径 (cm)	合并肝炎情况		肝功能分级	分化程度
组别	例	肿瘤直径 (cm)	有	无	A/B	高/中/低
Couinaud组	50	7.1±2.8	40	10	44/6	4/38/8
血流拓扑学组	50	7.4±2.6	38	12	46/4	3/41/6
t/χ²/Z		0.555	0.233		0.444	-0.243
P		0.290	0.629		0.505	0.808

组别	例	手术时间 (h)	术中出血量 (ml)		术中输血量 (ml)
Couinaud组	50	6.9±1.2	715.4±100.8		664.4±85.1
血流拓扑学组	50	6.5±1.0	682.8±84.5		628.7±74.8
t		1.811	1.753		2.228
P		0.037	0.042		0.014
组别	例	切除肝体积(ml)				术后住院时间(d)
组别	例	模拟切除肝		实际切除肝		术后住院时间(d)
Couinaud组	50	438.4±161.8		390.6±110.2^a		15.3±4.3
血流拓扑学组	50	379.8±123.3		353.9±102.6		13.7±3.1
t		2.037		1.724		2.134
P		0.022		0.044		0.018

组别	例	手术时间 (h)	术中出血量 (ml)		术中输血量 (ml)
Couinaud组	50	6.9±1.2	715.4±100.8		664.4±85.1
血流拓扑学组	50	6.5±1.0	682.8±84.5		628.7±74.8
t		1.811	1.753		2.228
P		0.037	0.042		0.014
组别	例	切除肝体积(ml)				术后住院时间(d)
组别	例	模拟切除肝		实际切除肝		术后住院时间(d)
Couinaud组	50	438.4±161.8		390.6±110.2^a		15.3±4.3
血流拓扑学组	50	379.8±123.3		353.9±102.6		13.7±3.1
t		2.037		1.724		2.134
P		0.022		0.044		0.018

组别	例	胸腔积液	腹腔出血	肺部感染	胆瘘	总并发症
Couinaud组	50	5(10.0)	1(2.0)	2(4.0)	2(4.0)	10(20.0)
血流拓扑学组	50	3(6.0)	0(0.0)	2(4.0)	1(2.0)	6(12.0)
χ²		-	-	-	-	0.380
P		-	-	-	-	0.538

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