实时增强现实腹腔镜导航在巨脾切除术治疗中的应用。

Application of Real-Time Augmented Reality Laparoscopic Navigation in Splenectomy for Massive Splenomegaly.

机构信息

Hepatic Surgery Center, Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.

Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.

出版信息

World J Surg. 2021 Jul;45(7):2108-2115. doi: 10.1007/s00268-021-06082-8. Epub 2021 Mar 26.

DOI:10.1007/s00268-021-06082-8

PMID:33770240

Abstract

OBJECTIVES

To evaluate the clinical impact and technical feasibility of augmented reality laparoscopic navigation (ARLN) system in laparoscopic splenectomy for massive splenomegaly.

METHODS

The clinical data of 17 consecutive patients who underwent laparoscopic splenectomy using ARLN (ARLN group) and 26 patients without ARLN guidance (Non-ARLN group) between January 2018 and April 2020 were enrolled. Propensity score matching (PSM) analysis was performed between the patients with and without ARLN guidance at a ratio of 1:1.

RESULTS

Mean intraoperative blood loss was significantly lower in the ARLN-group than in the Non-ARLN group (306.6 ml vs. 462.6 ml, p = 0.047). All the patients in the ARLN-group achieved successful splenic artery dissection, while surgical success was achieved in 12 patients in the Non-ARLN group (p = 0.044). Postoperative hospital stay was significantly longer in the Non-ARLN group (3.8 days vs. 4.5 days, p = 0.040).

CONCLUSIONS

ARLN can provide feasible and accurate intraoperative image guidance, and it could be helpful in the performance of laparoscopic splenectomy for massive splenomegaly.

摘要

目的

评估增强现实腹腔镜导航（ARLN）系统在巨脾腹腔镜脾切除术中的临床影响和技术可行性。

方法

回顾性分析 2018 年 1 月至 2020 年 4 月期间，17 例行腹腔镜脾切除术中应用 ARLN（ARLN 组）和 26 例无 ARLN 指导（非 ARLN 组）的连续患者的临床资料。按照 1:1 的比例进行倾向评分匹配（PSM）分析。

结果

ARLN 组术中出血量明显低于非 ARLN 组（306.6ml vs. 462.6ml，p=0.047）。ARLN 组所有患者均成功完成脾动脉解剖，而非 ARLN 组仅 12 例患者手术成功（p=0.044）。非 ARLN 组术后住院时间明显长于 ARLN 组（3.8 天 vs. 4.5 天，p=0.040）。