Wilasrusmee Chumpon, Suvikrom Jesada, Suthakorn Jackrit, Lertsithichai Panuwat, Sitthiseriprapip Kriskrai, Proprom Napaphat, Kittur Dilip S
Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University,270 Rama VI Road, Bangkok 10400, Thailand.
Int J Angiol. 2008 Fall;17(3):129-33. doi: 10.1055/s-0031-1278295.
Endovascular aortic aneurysm repair (EVAR) is a current valid treatment option for patients with abdominal aortic aneurysms (AAAs). The success of EVAR depends on the selection of appropriate patients, which requires detailed knowledge of the patient's vascular anatomy and preoperative planning. Three-dimensional (3D) models of AAA using a rapid prototyping technique were developed to help surgical trainees learn how to plan for EVAR more effectively.
Four cases of AAA were used as prototypes for the models. Nine questions associated with preoperative planning for EVAR were developed by a group of experts in the field of endovascular surgery. Forty-three postgraduate trainees in general surgery participated in the present study. The participants were randomly assigned into two groups. The 'intervention' group was provided with the rapid prototyping AAA models along with 3D computed tomography (CT) corresponding to the cases of the test, while the control group was provided with 3D CTs only.
Differences in the scores between the groups were tested using the unpaired t test. The mean test scores were consistently and significantly higher in the 3D CT group with models compared with the 3D CT group without models for all four cases. Age, year of training, sex and previous EVAR experience had no effect on the scores.
The 3D aortic aneurysm model constructed using the rapid prototype technique may significantly improve the ability of trainees to properly plan for EVAR.
血管内主动脉瘤修复术(EVAR)是目前治疗腹主动脉瘤(AAA)患者的有效方法。EVAR的成功取决于合适患者的选择,这需要详细了解患者的血管解剖结构并进行术前规划。利用快速成型技术构建了AAA的三维(3D)模型,以帮助外科实习生更有效地学习如何进行EVAR规划。
选取4例AAA病例作为模型原型。血管内外科领域的一组专家提出了9个与EVAR术前规划相关的问题。43名普通外科研究生参与了本研究。参与者被随机分为两组。“干预”组获得了快速成型的AAA模型以及与测试病例对应的3D计算机断层扫描(CT),而对照组仅获得3D CT。
使用不成对t检验对两组之间的分数差异进行了测试。在所有4例病例中,与没有模型的3D CT组相比,有模型的3D CT组的平均测试分数始终显著更高。年龄、培训年份、性别和既往EVAR经验对分数没有影响。
使用快速成型技术构建的3D主动脉瘤模型可能会显著提高实习生正确规划EVAR的能力。