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三维打印柔性模型:一种用于漏斗胸修复的努氏手术规划的新技术。

Three-dimensional printing flexible models: a novel technique for Nuss procedure planning of pectus excavatum repair.

作者信息

Wang Lei, Guo Ting, Zhang Hao, Yang Sanhu, Liang Jiahe, Guo Yitong, Shao Qiuya, Cao Tiesheng, Li Xiaofei, Huang Lijun

机构信息

Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China.

Department of Pain Management, The Affiliated Hospital of Northwest University (Xi'an No. 3 Hospital), Xi'an 710082, China.

出版信息

Ann Transl Med. 2020 Feb;8(4):110. doi: 10.21037/atm.2019.12.124.

Abstract

BACKGROUND

Pectus excavatum (PE), one of the most common congenital chest wall deformities, is characterized by posterior depression of the sternum and lower costal cartilages. In this study, we demonstrated the application of flexible three-dimensional printing thoracic models for surgical approach planning of extrapleural Nuss procedure for patients with pectus excavatum.

METHODS

Six patients with pectus excavatum were referred to our hospital for extrapleural Nuss procedure. Each patient's chest was reconstructed based on their computed tomography imaging data, and the three-dimensional (3D) thoracic model was manufactured with flexible material using 3D printing technique. The individual surgical approach and custom-made steel bars were designed and produced using these models.

RESULTS

The surgical approach was evaluated by using the three-dimensional thoracic model. In all patients received extrapleural Nuss surgery, it has been proven the uniformity of repair efficacy in both models and patients. Moreover, an individualized and well-fitting steel bar can be fabricated once the surgical approach was confirmed. All the steel bars were loaded against the ribs rigorously and seamlessly.

CONCLUSIONS

The flexible three-dimensional thoracic models were very helpful for the preoperative planning of extrapleural Nuss procedure.

摘要

背景

漏斗胸(PE)是最常见的先天性胸壁畸形之一,其特征为胸骨和下肋软骨向后凹陷。在本研究中,我们展示了柔性三维打印胸廓模型在漏斗胸患者胸膜外Nuss手术手术入路规划中的应用。

方法

6例漏斗胸患者被转诊至我院接受胸膜外Nuss手术。根据每位患者的计算机断层扫描成像数据重建其胸部,并使用3D打印技术用柔性材料制作三维(3D)胸廓模型。使用这些模型设计并制作个体化的手术入路和定制的钢棒。

结果

使用三维胸廓模型评估手术入路。在所有接受胸膜外Nuss手术的患者中,已证明模型和患者的修复效果具有一致性。此外,一旦确定手术入路,即可制造个体化且贴合良好的钢棒。所有钢棒均紧密且无缝地贴合肋骨。

结论

柔性三维胸廓模型对胸膜外Nuss手术的术前规划非常有帮助。

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本文引用的文献

1
Ultrasound-guided extrapleural Nuss procedure for pectus excavatum repair.超声引导下胸膜外Nuss手术治疗漏斗胸
Ann Thorac Surg. 2014 Nov;98(5):1863-4. doi: 10.1016/j.athoracsur.2014.04.065. Epub 2014 Oct 30.
4
Pectus excavatum: history, hypotheses and treatment options.漏斗胸:历史、假说与治疗选择
Interact Cardiovasc Thorac Surg. 2012 Jun;14(6):801-6. doi: 10.1093/icvts/ivs045. Epub 2012 Mar 5.

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