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混合现实在肝细胞癌肝切除术中的应用价值

Application value of mixed reality in hepatectomy for hepatocellular carcinoma.

作者信息

Zhu Liu-Yang, Hou Jian-Cun, Yang Long, Liu Zi-Rong, Tong Wen, Bai Yi, Zhang Ya-Min

机构信息

First Central Clinical College, Tianjin Medical University, Tianjin 300070, China.

Department of Hepatobiliary Surgery, Tianjin First Central Hospital, Tianjin 300192, China.

出版信息

World J Gastrointest Surg. 2022 Jan 27;14(1):36-45. doi: 10.4240/wjgs.v14.i1.36.

Abstract

BACKGROUND

As a new digital holographic imaging technology, mixed reality (MR) technology has unique advantages in determining the liver anatomy and location of tumor lesions. With the popularization of 5G communication technology, MR shows great potential in preoperative planning and intraoperative navigation, making hepatectomy more accurate and safer.

AIM

To evaluate the application value of MR technology in hepatectomy for hepatocellular carcinoma (HCC).

METHODS

The clinical data of 95 patients who underwent open hepatectomy surgery for HCC between June 2018 and October 2020 at our hospital were analyzed retrospectively. We selected 95 patients with HCC according to the inclusion criteria and exclusion criteria. In 38 patients, hepatectomy was assisted by MR (Group A), and an additional 57 patients underwent traditional hepatectomy without MR (Group B). The perioperative outcomes of the two groups were collected and compared to evaluate the application value of MR in hepatectomy for patients with HCC.

RESULTS

We summarized the technical process of MR-assisted hepatectomy in the treatment of HCC. Compared to traditional hepatectomy in Group B, MR-assisted hepatectomy in Group A yielded a shorter operation time (202.86 ± 46.02 min 229.52 ± 57.13 min, = 0.003), less volume of bleeding (329.29 ± 97.31 mL 398.23 ± 159.61 mL, = 0.028), and shorter obstructive time of the portal vein (17.71 ± 4.16 min 21.58 ± 5.24 min, = 0.019). Group A had lower alanine aminotransferas and higher albumin values on the third day after the operation (119.74 ± 29.08 U/L 135.53 ± 36.68 U/L, = 0.029 and 33.60 ± 3.21 g/L 31.80 ± 3.51 g/L, = 0.014, respectively). The total postoperative complications and hospitalization days in Group A were significantly less than those in Group B [14 (37.84%) 35 (60.34%), = 0.032 and 12.05 ± 4.04 d 13.78 ± 4.13 d, = 0.049, respectively].

CONCLUSION

MR has some application value in three-dimensional visualization of the liver, surgical planning, and intraoperative navigation during hepatectomy, and it significantly improves the perioperative outcomes of hepatectomy for HCC.

摘要

背景

作为一种新型数字全息成像技术,混合现实(MR)技术在确定肝脏解剖结构和肿瘤病变位置方面具有独特优势。随着5G通信技术的普及,MR在术前规划和术中导航方面显示出巨大潜力,使肝切除术更加精准和安全。

目的

评估MR技术在肝细胞癌(HCC)肝切除术中的应用价值。

方法

回顾性分析2018年6月至2020年10月在我院接受开放性HCC肝切除术的95例患者的临床资料。根据纳入标准和排除标准选取95例HCC患者。其中38例患者在MR辅助下进行肝切除术(A组),另外57例患者接受传统肝切除术(未使用MR)(B组)。收集两组患者的围手术期结果并进行比较,以评估MR在HCC患者肝切除术中的应用价值。

结果

总结了MR辅助肝切除术治疗HCC的技术过程。与B组的传统肝切除术相比,A组的MR辅助肝切除术手术时间更短(202.86±46.02分钟对229.52±57.13分钟,P = 0.003),出血量更少(329.29±97.31毫升对398.23±159.61毫升,P = 0.028),门静脉阻断时间更短(17.71±4.16分钟对21.58±5.24分钟,P = 0.019)。A组术后第三天丙氨酸转氨酶水平更低,白蛋白值更高(分别为119.74±29.08 U/L对135.53±36.68 U/L,P = 0.029;33.60±3.21 g/L对31.80±3.51 g/L,P = 0.014)。A组术后总并发症和住院天数明显少于B组[14例(37.84%)对35例(60.34%),P = 0.032;12.05±4.04天对13.78±4.13天,P = 0.049]。

结论

MR在肝切除术的肝脏三维可视化、手术规划和术中导航方面具有一定应用价值,显著改善了HCC肝切除术的围手术期结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6451/8790326/dfed027ba3ae/WJGS-14-36-g001.jpg

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