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三维物理模型辅助腹腔镜部分肾切除术治疗内生型肾肿瘤的规划和导航。

Three-Dimensional Physical Model-Assisted Planning and Navigation for Laparoscopic Partial Nephrectomy in Patients with Endophytic Renal Tumors.

机构信息

Department of Urology, The Affiliated Cancer Hospital of Xiangya School of Medicine of Central South University, Hunan Cancer Hospital, Changsha, 410013, China.

School of Public Health, Xiangnan University, Chenzhou, 423000, China.

出版信息

Sci Rep. 2018 Jan 12;8(1):582. doi: 10.1038/s41598-017-19056-5.

DOI:10.1038/s41598-017-19056-5
PMID:29330499
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5766569/
Abstract

Resection of completely endophytic renal tumors is a huge challenge for surgeons due to a lack of definite visual clues, especially in the laparoscopic approach. Three-dimensional (3D) kidney models, which can illustrate the clear relationship between renal masses and surrounding health tissues, were considered as reliable tools for understanding renal tumor characteristics in previous studies. We hypothesized that 3D kidney models can be used not only for planning but also for navigating laparoscopic partial nephrectomy (LPN) in patients with completely endophytic renal tumors. In this study, we successfully constructed five cases of 3D kidney models for assisted planning and navigation for LPN in endophytic renal tumors. The renal masses and surrounding normal parenchyma of the patient-specific 3D models were dyed by different colorants for clear illustration. All patients experienced acceptable perioperative outcomes, and no patient suffered serious relative complications. The 3D kidney models were considered as a reliable tool based on clinical outcome and postoperative questionnaire results. This study is the first report of 3D kidney models for patients with completely endophytic tumors. 3D kidney models can aid surgeons in understanding the characteristics of renal tumors and potentially support assisted planning and performance of LPN in endophytic tumor cases.

摘要

由于缺乏明确的视觉线索,完全内生性肾肿瘤的切除术对外科医生来说是一个巨大的挑战,尤其是在腹腔镜手术中。三维(3D)肾脏模型可以清楚地说明肾肿瘤与周围健康组织之间的关系,在之前的研究中被认为是了解肾肿瘤特征的可靠工具。我们假设 3D 肾脏模型不仅可以用于规划,还可以用于指导完全内生性肾肿瘤患者的腹腔镜部分肾切除术(LPN)。在这项研究中,我们成功地为 5 例内生性肾肿瘤的 LPN 辅助规划和导航构建了 3D 肾脏模型。患者特定的 3D 模型中的肾肿瘤和周围正常实质用不同的着色剂染色,以便清晰显示。所有患者的围手术期结果均可接受,无患者发生严重的相关并发症。基于临床结果和术后问卷调查结果,3D 肾脏模型被认为是一种可靠的工具。本研究是首例关于完全内生性肿瘤患者的 3D 肾脏模型报告。3D 肾脏模型可以帮助外科医生了解肾肿瘤的特征,并有可能支持辅助规划和内生性肿瘤病例中 LPN 的执行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f798/5766569/b05060920a84/41598_2017_19056_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f798/5766569/4bf17a3ad82b/41598_2017_19056_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f798/5766569/7865818d2da4/41598_2017_19056_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f798/5766569/1fa4fd9ca299/41598_2017_19056_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f798/5766569/e438a9c58447/41598_2017_19056_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f798/5766569/b05060920a84/41598_2017_19056_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f798/5766569/4bf17a3ad82b/41598_2017_19056_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f798/5766569/7865818d2da4/41598_2017_19056_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f798/5766569/1fa4fd9ca299/41598_2017_19056_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f798/5766569/e438a9c58447/41598_2017_19056_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f798/5766569/b05060920a84/41598_2017_19056_Fig5_HTML.jpg

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