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混合现实实时导航联合三维可视化在复杂肝切除术中的应用

[Application of mixed reality real-time navigation combined with 3D visualization in complicated hepatectomy].

作者信息

Ma C Y, Zhou Y L, Li H L, Hou W X, Shao B F, Zhang S Q, Li G X, Liu H F, Chen Y, Zhang Y X

机构信息

Nantong Tumour Hospital of Jiangsu, Nantong 226300 China.

Oncology Major, Department of Clinical Medicine, Graduate School of Medical College, Nantong University, Nantong, 226019 China.

出版信息

Zhonghua Yi Xue Za Zhi. 2019 Jan 22;99(4):279-283. doi: 10.3760/cma.j.issn.0376-2491.2019.04.008.

Abstract

To explore the application value of mixed-reality (MR) navigation combined with three-dimensional visualization technique in complicated hepatectomy. A retrospective analysis of the clinical data of fifty patients with complex liver cancer who underwent liver resection in the Department of hepatobiliary surgery of Nantong Tumor Hospital during September 2015 to October 2017 was conducted. These patients were randomly divided into control group and experimental group, including 22 cases in the experimental group, using three-dimensional visualization technique for preoperative assessment, and MR surgery intraoperative navigation technology, and 28 cases in the control group, in which the three-dimensional visualization technique and the MR navigation were not performed. The surgeons of the two groups were the same. The preoperative, intraoperative and postoperative indexes of the two groups were compared and analyzed. There was no significant difference in preoperative indexes. But in the intraoperative indexes, the operation time [(82.3±10.4) min vs (96.6±22.7) min] and hepatic portal blocking time [(12.2±3.8) min VS (15.8±4.2) min] of the experimental group were significantly shorter than those of the control group, meanwhile, the amount of intraoperative bleeding [(486.4±118.5) ml vs (567.2±142.8) ml] and the volume of intraoperative blood transfusion of [(1.8±0.2) U vs (2.5±0.6) U] were significantly decreased. These differences were statistically significant. In the postoperatively, the total incidence of postoperative complications (4/22 vs 13/28) of the experimental group was lower than that of the control group, and the difference was statistically significant. In complicated hepatectomy, MR intraoperative navigation combined with three-dimensional visualization technique which used for preoperative assessment can significantly shorten operation time, hepatic portal blocking time, significantly reduce intraoperative blood loss and transfusion volume, and significantly reduce the incidence of postoperative total complications, which is of clinical value.

摘要

探讨混合现实(MR)导航联合三维可视化技术在复杂肝切除术中的应用价值。对2015年9月至2017年10月在南通肿瘤医院肝胆外科行肝切除的50例复杂肝癌患者的临床资料进行回顾性分析。将这些患者随机分为对照组和实验组,实验组22例,采用三维可视化技术进行术前评估及MR手术术中导航技术;对照组28例,未采用三维可视化技术及MR导航。两组手术医生相同。比较分析两组患者术前、术中和术后指标。术前指标无显著差异。但术中指标方面,实验组的手术时间[(82.3±10.4)分钟 vs(96.6±22.7)分钟]和肝门阻断时间[(12.2±3.8)分钟 vs(15.8±4.2)分钟]明显短于对照组,同时,术中出血量[(486.4±118.5)毫升 vs(567.2±142.8)毫升]和术中输血量[(1.8±0.2)单位 vs(2.5±0.6)单位]明显减少。这些差异具有统计学意义。术后,实验组术后并发症总发生率(4/22 vs 13/28)低于对照组,差异具有统计学意义。在复杂肝切除术中,用于术前评估的MR术中导航联合三维可视化技术可显著缩短手术时间、肝门阻断时间,显著减少术中出血量和输血量,并显著降低术后总并发症发生率,具有临床应用价值。

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