Cromeens Barrett P, Ray William C, Hoehne Brad, Abayneh Fikir, Adler Brent, Besner Gail E
Department of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio.
Battelle Center for Mathematical Medicine, Nationwide Children's Hospital, Columbus, Ohio.
J Surg Res. 2017 Aug;216:18-25. doi: 10.1016/j.jss.2017.04.003. Epub 2017 Apr 21.
3-dimensional prints (3DP) anecdotally facilitate surgeon understanding of anatomy and decision-making. However, the actual benefit to surgeons or patients has not been quantified. This study investigates how surgeon understanding of complex anatomy is altered by a 3DP compared to computed tomography (CT) scan or CT + digital reconstruction (CT + DR).
Key anatomic features were segmented from a CT-abdomen/pelvis of pygopagus twins to build a DR and printed in color on a 3D printer. Pediatric surgery trainees and attendings (n = 21) were tested regarding anatomy identification and their understanding of point-to-point distances, scale, and shape.
There was no difference between media regarding point-to-point distances. The 3DP led to an increased number of correct answers for questions of scale and shape compared to CT (P < 0.05). CT + DR performance was intermediate but not statistically different from 3DP or CT. Identification of anatomy was inconsistent between media; however, answers were significantly closer to correct when using the 3DP. Participants completed the test faster with the 3DP (6.6 ± 0.5 min) (P < 0.05) than with CT (18.9 ± 2.5 min) or CT + 3DR (14.9 ± 1.5 min).
Although point-to-point measurements were not different, 3DP increased the understanding of shape, scale, and anatomy. It enabled understanding significantly faster than other media. In difficult surgical cases with complex anatomy and a need for efficient multidisciplinary coordination, 3D printed models should be considered for surgical planning.
据传闻，三维打印（3DP）有助于外科医生理解解剖结构并进行决策。然而，其对外科医生或患者的实际益处尚未得到量化。本研究调查了与计算机断层扫描（CT）或CT + 数字重建（CT + DR）相比，3DP如何改变外科医生对复杂解剖结构的理解。
从臀联体双胞胎的腹部/盆腔CT中分割出关键解剖特征以构建数字重建（DR），并在3D打印机上进行彩色打印。对小儿外科实习生和主治医生（n = 21）进行了解剖结构识别测试，以及他们对点对点距离、比例和形状的理解测试。
不同媒介之间在点对点距离方面没有差异。与CT相比，3DP在比例和形状问题上的正确答案数量增加（P < 0.05）。CT + DR的表现处于中间水平，但与3DP或CT在统计学上没有差异。不同媒介之间解剖结构的识别不一致；然而，使用3DP时答案明显更接近正确答案。参与者使用3DP（6.6 ± 0.5分钟）完成测试的速度比使用CT（18.9 ± 2.5分钟）或CT + 3DR（14.9 ± 1.5分钟）更快（P < 0.05）。
尽管点对点测量没有差异，但3DP增强了对形状、比例和解剖结构的理解。它使理解速度明显快于其他媒介。在解剖结构复杂且需要高效多学科协作的困难手术病例中，手术规划时应考虑使用3D打印模型。
