Li C R, Yu Q L, Yang B, Zhang B, Liu Y
Department of Thoracic Surgery, the First Medical Center of People's Liberation Army General Hospital, Beijing 100853, China.
the First Medical Center of People's Liberation Army General Hospital, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2020 Aug 18;100(31):2452-2456. doi: 10.3760/cma.j.cn112137-20200207-00214.
To investigate the clinical value of holographic multimodal real-time three-dimensional navigation (3D-HMRN) technology for navigation and localization of pulmonary micro lesions. A total of 152 patients who underwent thoracoscopic partial resection of small pulmonary nodules in the Department of Thoracic Surgery of the First Medical Center of Chinese PLA General Hospital from June 2017 to December 2019 were retrospectively collected and were divided into two groups by computer random number. The experimental group consists of 76 patients (31 males and 45 females) with a mean age of (47±17) years. CT scan in lateral position navigation mode and 3D reconstruction of the surgical area were performed on all patients. Before the operation, holographic multimodal real-time 3D navigation technology was used to guide the puncture of the lesion. After the operation was completed, the intraoperative CT was used to verify the location of the puncture and determine the accuracy and error rang of the puncture. The control group consists of 76 patients (34 males and 42 females) with a mean age of (50±19) years. Intraoperative CT positioning was directly subjected to the patients. And then, the localization data of the two groups were compared and statistically analyzed. Seventy-six cases of positioning puncture using navigation technology, the first success rate was 97.4%, the error was (3.9±0.9) mm, and the average operation time was (4.4±1.2) min; while the success rate of one-time CT positioning during routine surgery was 98.7%, the error was (3.5±1.0) mm, and the average operating time was (10.7±2.6) min. Compared with intraoperative CT positioning, the success rate and positioning accuracy of 3D-HMRN were not statistically significant (both 0.05), however the operation time was significantly shortened (0.01). The holographic multi-modal real-time 3D navigation technology saves time and has accurate positioning, which may be used as an effective method for localization of pulmonary micro nodules during surgical treatment.
探讨全息多模态实时三维导航（3D - HMRN）技术在肺微小病变导航定位中的临床应用价值。回顾性收集2017年6月至2019年12月在中国人民解放军总医院第一医学中心胸外科行胸腔镜下小肺结节部分切除术的152例患者，通过计算机随机数分为两组。实验组76例（男31例，女45例），平均年龄（47±17）岁。所有患者均行侧卧位导航模式CT扫描及手术区域三维重建。术前采用全息多模态实时三维导航技术引导病变穿刺。手术完成后，采用术中CT验证穿刺位置，确定穿刺的准确性及误差范围。对照组76例（男34例，女42例），平均年龄（50±19）岁，患者直接行术中CT定位。然后，对两组的定位数据进行比较并统计分析。采用导航技术定位穿刺76例，首次成功率为97.4%，误差为（3.9±0.9）mm，平均手术时间为（4.4±1.2）min；而常规手术中一次性CT定位成功率为98.7%，误差为（3.5±1.0）mm，平均手术时间为（10.7±2.6）min。与术中CT定位相比，3D - HMRN的成功率和定位准确性差异无统计学意义（均>0.05），但手术时间明显缩短（<0.01）。全息多模态实时三维导航技术省时且定位准确，可作为手术治疗中肺微小结节定位的有效方法。
