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基于高分辨率CT的三维图像重建技术在肾盂成形术中的应用

Application of three-dimensional image reconstruction technology based on high-resolution CT in pyeloplasty.

作者信息

Li Xuechao, Zhang Jingyun, Shi Weiqing, Yang Tao, Lu Rongjian, Zhao Xiaoling, Chen Lijun

机构信息

Medical School of Chinese PLA, Beijing, China.

Fifth Medical Centre of Chinese PLA General Hospital, Beijing, China.

出版信息

Transl Androl Urol. 2021 Mar;10(3):1314-1320. doi: 10.21037/tau-21-202.

Abstract

BACKGROUND

Three-dimensional (3D) image reconstruction technology is widely used in surgical operations for its intuitive visualization. Pyeloplasty requiresprecise cutting and suturing. The reconstruction technology can accurately determine the location and scope of the stenosis at the junction of the renal pelvis and ureter and the relationship with the surrounding vasculature. The purpose of this article is to retrospective evaluate the application value of image reconstruction technology in pyeloplasty based on high-resolution 3D CT images.

METHODS

A total of 20 patients with renal pelvic ureteral junction obstruction admitted to our hospital from August 2019 to August 2020 were selected. In this group, left pyeloplasty was performed in 8 patients and right pyeloplasty in 12 patients. In terms of conditions, there was 1 case with secondary pyeloplasty, 6 cases of patients with kidney stones, 2 cases with renal ectopic blood vessels, 1 case with renal prolapse, 1 case with horseshoe kidney, and 1 case with ureteral polyps. There were 12 males and 8 females, with an average age of 34.65±10.67 years and an average body mass index (BMI) of 22.48±3.03 kg/m. In all patients, 3D CT reconstruction technology was used to guide the formulation of robot-assisted laparoscopic pyeloplasty plans; verify the consistency between the actual operation and the preoperative planning; and observe the operation time, blood loss, postoperative exhaust time, indwelling drainage tube time, and follow-up for comorbidities.

RESULTS

The operation was successful in all 20 patients. The actual operation was 100% consistent with the preoperative planning, the operative time was 160.80±63.26 min, the intraoperative blood loss was 47±30.45 mL, the postoperative exhaust time was 1.15±0.37 days, the drainage tube indwelling time was 4.35±1.50 days, and the average follow-up time was 7.95±3.41 months. There were no complications.

CONCLUSIONS

Three-dimensional image reconstruction technology based on high-resolution CT has high clinical application value in the treatment of ureteropelvic junction obstruction (UPJO), which simplifies the operation process and shortens the operation time, and is a valuable tool for auxiliary surgeons in devising the operation plan.

摘要

背景

三维(3D)图像重建技术因其直观的可视化效果在外科手术中被广泛应用。肾盂成形术需要精确的切割和缝合。该重建技术能够准确确定肾盂输尿管连接处狭窄的位置和范围以及与周围血管系统的关系。本文旨在基于高分辨率3D CT图像回顾性评估图像重建技术在肾盂成形术中的应用价值。

方法

选取2019年8月至2020年8月我院收治的20例肾盂输尿管连接处梗阻患者。该组中,8例行左侧肾盂成形术,12例行右侧肾盂成形术。病情方面,二次肾盂成形术1例,肾结石患者6例,肾异位血管2例,肾下垂1例,马蹄肾1例,输尿管息肉1例。男性12例,女性8例,平均年龄34.65±10.67岁,平均体重指数(BMI)为22.48±3.03kg/m。所有患者均采用3D CT重建技术指导制定机器人辅助腹腔镜肾盂成形术方案;验证实际手术与术前规划的一致性;并观察手术时间、出血量、术后排气时间、留置引流管时间以及随访合并症情况。

结果

20例患者手术均成功。实际手术与术前规划100%一致,手术时间为160.80±63.26分钟,术中出血量为47±30.45毫升,术后排气时间为1.15±0.37天,引流管留置时间为4.35±1.50天,平均随访时间为7.95±3.41个月。无并发症发生。

结论

基于高分辨率CT的三维图像重建技术在治疗输尿管肾盂连接处梗阻(UPJO)方面具有较高的临床应用价值,简化了手术过程,缩短了手术时间,是辅助外科医生制定手术方案的宝贵工具。

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