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三维打印在胸腔镜肺段切除术术前规划中的应用

Three-dimensional printing in the preoperative planning of thoracoscopic pulmonary segmentectomy.

作者信息

Liu Xiaojun, Zhao Yandong, Xuan Yunpeng, Lan Xinyan, Zhao Jun, Lan Xiaoquan, Han Bin, Jiao Wenjie

机构信息

Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, China.

Department of Thoracic Surgery, Qingdao Chengyang District People's Hospital, Qingdao 266003, China.

出版信息

Transl Lung Cancer Res. 2019 Dec;8(6):929-937. doi: 10.21037/tlcr.2019.11.27.

Abstract

BACKGROUND

The purpose of this study is to explore whether 3D printing has a better clinical value for making a preoperative plan than three-dimensional computed tomography (3D-CT) in thoracoscopic pulmonary segmentectomy.

METHODS

We collected a total of 124 patients' clinical data who underwent thoracoscopic pulmonary segmentectomy from October 2017 to August 2018. According to the preoperative examination, the patients were divided into three groups: general group, 3D-CT group, and 3D printing group. The clinical data of each group were analyzed and compared.

RESULTS

Compared with the general group, intraoperative blood loss in 3D-CT group and 3D printing group decreased significantly (P<0.05). Operation time in 3D-CT group and 3D printing group was significantly shorter than in the general group (P<0.05). Between 3D-CT group and 3D printing group intraoperative blood loss and operation time had no significant differences (P>0.05). Postoperative chest tube duration and postoperative hospital stay had no significant differences between each group P>0.05). The incidence of postoperative hemoptysis in the general group occurred higher than in the 3D-CT group and 3D printing group, but the differences were not statistically significant (P>0.05). Postoperative complications of pneumonia, atelectasis, and pulmonary air leakage (>6 d) had no significant differences between each group (P>0.05).

CONCLUSIONS

3D printing and 3D-CT for making a preoperative plan have an equivalent effect in thoracoscopic pulmonary segmentectomy for experienced surgeons. Preoperative simulations using 3D printing for the assessment of pulmonary vessel and bronchi branching patterns is beneficial for the safe and efficient performance of thoracoscopic pulmonary segmentectomy.

摘要

背景

本研究旨在探讨在胸腔镜肺段切除术中,与三维计算机断层扫描(3D-CT)相比,3D打印在制定术前计划方面是否具有更好的临床价值。

方法

我们收集了2017年10月至2018年8月期间接受胸腔镜肺段切除术的124例患者的临床资料。根据术前检查,将患者分为三组:普通组、3D-CT组和3D打印组。对每组的临床资料进行分析和比较。

结果

与普通组相比,3D-CT组和3D打印组的术中出血量显著减少(P<0.05)。3D-CT组和3D打印组的手术时间明显短于普通组(P<0.05)。3D-CT组和3D打印组之间的术中出血量和手术时间无显著差异(P>0.05)。每组之间术后胸管留置时间和术后住院时间无显著差异(P>0.05)。普通组术后咯血发生率高于3D-CT组和3D打印组,但差异无统计学意义(P>0.05)。每组之间术后肺炎、肺不张和肺漏气(>6天)的并发症无显著差异(P>0.05)。

结论

对于有经验的外科医生,在胸腔镜肺段切除术中,3D打印和3D-CT在制定术前计划方面具有同等效果。使用3D打印进行术前模拟以评估肺血管和支气管分支模式,有利于胸腔镜肺段切除术的安全高效实施。

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本文引用的文献

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Unplanned Procedures During Thoracoscopic Segmentectomies.胸腔镜肺段切除术期间的非计划手术
Ann Thorac Surg. 2017 Nov;104(5):1710-1717. doi: 10.1016/j.athoracsur.2017.05.081. Epub 2017 Sep 29.

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