Division of Hepato-Billiary-Pancreatic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.
Am J Surg. 2013 Oct;206(4):530-8. doi: 10.1016/j.amjsurg.2013.01.041. Epub 2013 Jun 27.
The aim of this study was to evaluate whether 3-dimensional (3D) simulation software is applicable to and useful for anatomic liver segmentectomy and subsegmentectomy.
A prospective study of 83 consecutive patients who underwent anatomic segmentectomy or subsegmentectomy using the puncture method was performed. All patients underwent 3D simulation analysis (SA) preoperatively for planning operative procedures. The clinical information acquired by 3D SA and the consistency of virtual and real hepatectomy were evaluated.
The time needed for completing 3D SA was 18.3 ± .7 minutes. Three-dimensional SA proposed resection of multiple segments or subsegments in 29 patients (35%). It also helped complement the resection line in 26 patients (31%) who lacked a bold staining area on the liver surface. The volume of segment or subsegment calculated by 3D SA was correlated with the actual resected specimen (R(2) = .9942, P < .01). The bordering hepatic veins were clearly exposed in 71 patients (86%), in accordance with completed drawings by 3D SA.
Three-dimensional SA showed accurate completed drawings and assisted liver surgeons in planning and executing anatomic segmentectomy and subsegmentectomy.
本研究旨在评估三维（3D）模拟软件是否适用于解剖性肝段切除术和亚段切除术，并具有实际应用价值。
前瞻性研究了 83 例连续接受穿刺法解剖性肝段切除术或亚段切除术的患者。所有患者术前均进行 3D 模拟分析（SA）以规划手术过程。评估了 3D SA 获得的临床信息和虚拟与真实肝切除术的一致性。
完成 3D SA 所需的时间为 18.3±0.7 分钟。3D SA 提出了 29 例（35%）患者的多个肝段或亚段切除术建议，并帮助 26 例（31%）患者补充了肝表面无大胆染色区域的切除线。3D SA 计算的肝段或亚段体积与实际切除标本相关（R²=0.9942，P<.01）。71 例（86%）患者的边界肝静脉清晰显露，与 3D SA 的完成绘图一致。
3D SA 显示出准确的完成绘图，并有助于肝外科医生规划和执行解剖性肝段切除术和亚段切除术。
