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肾血管肿瘤解剖结构的三维重建,以促进部分肾切除术的准确术前规划。

Three-dimensional Reconstruction of Renal Vascular Tumor Anatomy to facilitate accurate preoperative planning of partial nephrectomy.

作者信息

Lin Wei-Ching, Chang Chao-Hsiang, Chang Yi-Huei, Lin Chien-Heng

机构信息

Department of Medical Imaging, China Medical University Hospital, Taichung, 40447, Taiwan.

College of Medicine, China Medical University, Taichung, 40402, Taiwan.

出版信息

Biomedicine (Taipei). 2020 Dec 1;10(4):36-41. doi: 10.37796/2211-8039.1078. eCollection 2020.

Abstract

OBJECTIVES

To evaluate the role of three-dimensional (3D) reconstruction tumors and vessels of the kidneys in aiding the preoperative planning of partial nephrectomy.

MATERIALS AND METHODS

Patients with renal tumors to be treated with partial nephrectomy were included. Each patient underwent a preoperative computed tomography (CT) survey, and the reconstruction of each patient's 3D arteriography and 3D surface-rendered tumor was performed based on the CT images for preoperative surgical planning.

RESULTS

A total of 6 patients, three with tumors of the right kidney and three with tumors of the left kidney, were enrolled in the study. The patients' mean age was 49.33 ± 4.03 years (range: 45-57 years), and their mean tumor size was 4.4 ± 1.84 cm (range: 2.2-6.8 cm). Four underwent robot-assisted laparoscopic partial nephrectomies, one underwent a traditional laparoscopic partial nephrectomy, and one underwent a radical nephrectomy through laparotomy. Their average postoperative hospital stay was 6.7 days (range: 3-10 days). No intraoperative or postoperative complications were noted. The renal function was preserved in all the patients, and none of the patients exhibited evidence of local recurrence during more than 6 years of follow-up.

CONCLUSIONS

3D arteriography fused with 3D surface-rendered tumor image navigation facilitates precise preoperative planning.

摘要

目的

评估肾脏肿瘤及血管的三维(3D)重建在辅助肾部分切除术术前规划中的作用。

材料与方法

纳入拟行肾部分切除术治疗的肾肿瘤患者。每位患者均接受术前计算机断层扫描(CT)检查,并基于CT图像对每位患者进行3D动脉造影及3D表面渲染肿瘤重建,以进行术前手术规划。

结果

本研究共纳入6例患者,其中3例为右肾肿瘤,3例为左肾肿瘤。患者平均年龄为49.33±4.03岁(范围:45 - 57岁),平均肿瘤大小为4.4±1.84 cm(范围:2.2 - 6.8 cm)。4例行机器人辅助腹腔镜肾部分切除术,1例行传统腹腔镜肾部分切除术,1例行开放性根治性肾切除术。他们术后平均住院时间为6.7天(范围:3 - 10天)。未观察到术中或术后并发症。所有患者肾功能均得以保留,且在超过6年的随访期间,无一例患者出现局部复发迹象。

结论

3D动脉造影与3D表面渲染肿瘤图像导航相结合有助于精确的术前规划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b399/7735978/6c72203debf5/bmed-10-04-036f1.jpg

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