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三维打印在骨科创伤手术术前规划中的应用:一项系统评价和荟萃分析。

Use of three-dimensional printing in preoperative planning in orthopaedic trauma surgery: A systematic review and meta-analysis.

作者信息

Morgan Catrin, Khatri Chetan, Hanna Sammy A, Ashrafian Hutan, Sarraf Khaled M

机构信息

Trauma and Orthopaedics, Imperial College NHS Trust, London W2 1NY, United Kingdom.

The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, United Kingdom.

出版信息

World J Orthop. 2020 Jan 18;11(1):57-67. doi: 10.5312/wjo.v11.i1.57.

Abstract

BACKGROUND

With the increasing complexity of surgical interventions performed in orthopaedic trauma surgery and the improving technologies used in three-dimensional (3D) printing, there has been an increased interest in the concept. It has been shown that 3D models allow surgeons to better visualise anatomy, aid in planning and performing complex surgery. It is however not clear how best to utilise the technique and whether this results in better outcomes.

AIM

To evaluate the effect of 3D printing used in pre-operative planning in orthopaedic trauma surgery on clinical outcomes.

METHODS

We performed a comprehensive systematic review of the literature and a meta-analysis. Medline, Ovid and Embase were searched from inception to February 8, 2018. Randomised controlled trials, case-control studies, cohort studies and case series of five patients or more were included across any area of orthopaedic trauma. The primary outcomes were operation time, intra-operative blood loss and fluoroscopy used.

RESULTS

Seventeen studies (922 patients) met our inclusion criteria and were reviewed. The use of 3D printing across all specialties in orthopaedic trauma surgery demonstrated an overall reduction in operation time of 19.85% [95% confidence intervals (CI): (-22.99, -16.71)], intra-operative blood loss of 25.73% [95%CI: (-31.07, -20.40)], and number of times fluoroscopy was used by 23.80% [95%CI: (-38.49, -9.10)].

CONCLUSION

Our results suggest that the use of 3D printing in pre-operative planning in orthopaedic trauma reduces operative time, intraoperative blood loss and the number of times fluoroscopy is used.

摘要

背景

随着骨科创伤手术中外科干预的复杂性不断增加以及三维(3D)打印技术的不断改进,人们对这一概念的兴趣日益浓厚。研究表明,3D模型能让外科医生更好地可视化解剖结构,有助于复杂手术的规划和实施。然而,目前尚不清楚如何最佳地利用这项技术,以及这是否会带来更好的手术效果。

目的

评估骨科创伤手术术前规划中使用3D打印对临床效果的影响。

方法

我们对文献进行了全面的系统评价和荟萃分析。检索了从创刊至2018年2月8日的Medline、Ovid和Embase数据库。纳入了骨科创伤任何领域的随机对照试验、病例对照研究、队列研究以及五例或以上患者的病例系列。主要结局指标为手术时间、术中失血量和使用透视的次数。

结果

17项研究(922例患者)符合纳入标准并进行了综述。在骨科创伤手术的所有专科中使用3D打印,结果显示手术时间总体减少了19.85% [95%置信区间(CI):(-22.99,-16.71)],术中失血量减少了25.73% [95%CI:(-31.07,-20.40)],透视使用次数减少了23.80% [95%CI:(-38.49,-9.10)]。

结论

我们的结果表明,骨科创伤手术术前规划中使用3D打印可减少手术时间、术中失血量和透视使用次数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2f1/6960300/9a4703730ffd/WJO-11-57-g001.jpg

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