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三维打印辅助技术在腹膜后肿瘤完全安全切除中的应用规划。

Three-dimensional printing - Assisted planning for complete and safe resection of retroperitoneal tumor.

机构信息

Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

J Xray Sci Technol. 2020;28(3):471-480. doi: 10.3233/XST-190636.

Abstract

BACKGROUND

Surgery is usually recommended to treat retroperitoneal tumors. However, complete surgical resections often remain challenging.

OBJECTIVE

To assess the assistant role of three-dimensional (3D) imaging and printing model in retroperitoneal tumor resection, as well as compare the difference between 3D printing and computed tomography (CT) in preoperative planning and confidence building.

METHODS

We admitted a patient with retroperitoneal mass (13.0×6.4×14.8 cm) adjacent to important abdominal blood vessels whose surgery was thought to be difficult. 3D printing and CT was arranged. A novel questionnaire and scoring system consisting of surgery difficulty and safety were designed to compare doctors understanding and confidence for surgery based on 3D printing and CT. Twenty-four doctors completed the scoring table based on CT and then 3D imaging, respectively. Paired t-test was applied for statistics analysis.

RESULTS

Preoperative evaluation based on 3D printing indicated that the tumor could be removed completely. The operation lasted 120 minutes to successfully remove the tumor and the estimated blood loss was less than 100 ml. Scores based on 3D printing is significantly higher than CT in difficulty and safety of surgery (p < 0.001). Interestingly, the junior doctors seem to benefit more from 3D printing than the senior doctors.

CONCLUSIONS

3D imaging and printing model provides greater help for preoperative planning and confidence building than using CT in resection of retroperitoneal tumor, especially for the junior doctors.

摘要

背景

手术通常被推荐用于治疗腹膜后肿瘤。然而,完全的手术切除往往具有挑战性。

目的

评估三维(3D)成像和打印模型在腹膜后肿瘤切除中的辅助作用,并比较 3D 打印和计算机断层扫描(CT)在术前规划和信心建立方面的差异。

方法

我们收治了一名腹膜后肿块(13.0×6.4×14.8cm)的患者,该肿块毗邻重要的腹部血管,手术难度大。安排了 3D 打印和 CT。设计了一种新的问卷和评分系统,包括手术难度和安全性,以比较医生基于 3D 打印和 CT 对手术的理解和信心。24 名医生分别根据 CT 和 3D 成像完成了评分表。应用配对 t 检验进行统计学分析。

结果

基于 3D 打印的术前评估表明肿瘤可以完全切除。手术持续 120 分钟,成功切除肿瘤,估计出血量少于 100ml。基于 3D 打印的手术难度和安全性评分明显高于 CT(p<0.001)。有趣的是,初级医生似乎比高级医生从 3D 打印中获益更多。

结论

3D 成像和打印模型在腹膜后肿瘤切除的术前规划和信心建立方面比 CT 提供了更大的帮助,特别是对初级医生而言。

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