He Yi-Biao, Bai Lei, Aji Tuerganaili, Jiang Yi, Zhao Jin-Ming, Zhang Jin-Hui, Shao Ying-Mei, Liu Wen-Ya, Wen Hao
Yi-Biao He, Lei Bai, Tuerganaili Aji, Jin-Ming Zhao, Jin-Hui Zhang, Ying-Mei Shao, Hao Wen, Liver and Laparoscopic Surgery Department, Digestive and Vascular Surgery Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uyghur Autonomous Region, China.
World J Gastroenterol. 2015 Sep 21;21(35):10200-7. doi: 10.3748/wjg.v21.i35.10200.
To evaluate the reliability and accuracy of three-dimensional (3D) reconstruction for liver resection in patients with hepatic alveolar echinococcosis (HAE).
One-hundred and six consecutive patients with HAE underwent hepatectomy at our hospital between May 2011 and January 2015. Fifty-nine patients underwent preoperative 3D reconstruction and "virtual" 3D liver resection before surgery (Group A). Another 47 patients used conventional imaging methods for preoperative assessment (Group B). Outcomes of hepatectomy were compared between the two groups.
There was no significant difference in preoperative data between the two groups. Compared with patients in Group B, those in Group A had a significantly shorter operation time (227.1 ± 51.4 vs 304.6 ± 88.1 min; P < 0.05), less intraoperative blood loss (308.1 ± 135.4 vs 458.1 ± 175.4 mL; P < 0.05), and lower requirement for intraoperative blood transfusion (186.4 ± 169.6 vs 289.4 ± 199.2 mL; P < 0.05). Estimated resection liver volumes in both groups had good correlation with actual graft weight (Group A: r = 0.978; Group B: r = 0.960). There was a significant higher serum level of albumin in Group A (26.3 ± 5.9 vs 22.6 ± 4.3 g/L, P < 0.05). Other postoperative laboratory parameters (serum levels of aminotransferase and bilirubin; prothrombin time) and duration of postoperative hospital stay were similar. Sixteen complications occurred in Group A and 19 in Group B. All patients were followed for 3-46 (mean, 17.3) mo. There was no recurrence of lesions in Group A, but two recurrences in Group B. There were three deaths: two from cerebrovascular accident, and one from car accident.
3D reconstruction provides comprehensive and precise anatomical information for the liver. It also improves the chance of success and reduces the risk of hepatectomy in HAE.
评估三维（3D）重建在肝泡型包虫病（HAE）患者肝切除术中的可靠性和准确性。
2011年5月至2015年1月期间，我院连续106例HAE患者接受了肝切除术。59例患者在术前进行了3D重建和术前“虚拟”3D肝切除术（A组）。另外47例患者采用传统成像方法进行术前评估（B组）。比较两组肝切除术的结果。
两组术前数据无显著差异。与B组患者相比，A组患者的手术时间明显缩短（227.1±51.4对304.6±88.1分钟；P<0.05），术中出血量更少（308.1±135.4对458.1±175.4毫升；P<0.05），术中输血需求更低（186.4±169.6对289.4±199.2毫升；P<0.05）。两组估计切除肝脏体积与实际移植肝重量均具有良好的相关性（A组：r=0.978；B组：r=0.960）。A组血清白蛋白水平显著更高（26.3±5.9对22.6±4.3克/升，P<0.05）。其他术后实验室参数（血清转氨酶和胆红素水平；凝血酶原时间）及术后住院时间相似。A组发生16例并发症，B组发生19例并发症。所有患者均随访3至46（平均17.3）个月。A组无病变复发，但B组有2例复发。有3例死亡：2例死于脑血管意外，1例死于车祸。
3D重建为肝脏提供了全面而精确的解剖信息。它还提高了肝泡型包虫病肝切除术的成功率并降低了风险。
