Liu Jie, Xiu Wenli, Duan Guangqi, Dong Qian
Department of Pediatric Surgery, Yijishan Hospital of Wannan Medical College, Wannan Medical College, Wuhu, China.
Department of Pediatric Surgery, Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China.
Front Surg. 2022 Jun 1;9:908381. doi: 10.3389/fsurg.2022.908381. eCollection 2022.
This study aims to explore the clinical value of a computer-assisted surgery system (Hisense CAS) in hepatoblastoma (HB) surgery in children after neoadjuvant chemotherapy.
The clinical medical records of children with HB treated after neoadjuvant chemotherapy at the Affiliated Hospital of Qingdao University from January 2016 to January 2019 were analyzed retrospectively.
A total of 21 children were enrolled in this study, including 13 boys and 8 girls. All cases successfully underwent three-dimensional (3D) reconstruction of the liver and tumor using Hisense CAS, simulated hepatectomy, and hepatectomy according to the preoperative operation plan. There were twelve cases of right hemihepatectomy, four cases of right trefoil hepatectomy, one case of left lobe hepatectomy, and three cases of middle lobe hepatectomy, and one case of V and VI segment hepatectomy. All children recovered well after the operation. The follow-up ranged from 5 months to 3 years. One child died of systemic metastasis 8 months after the operation. One child received one course of chemotherapy after the operation. Due to the serious reaction to the chemotherapy, the family refused further treatment and follow-up. The remaining 19 children had no complications or recurrence.
Hisense CAS can clearly and intuitively display the position and shape of the HB before and after chemotherapy and its relationship with the intrahepatic pipeline system and accurately evaluate the changes in tumor volume and the distance between important blood vessels, which is conducive to the operator selecting the best operation opportunity, timely formulating the best operation plan and implementing individualized and accurate liver tumor resection.
本研究旨在探讨计算机辅助手术系统（海信CAS）在新辅助化疗后儿童肝母细胞瘤（HB）手术中的临床价值。
回顾性分析2016年1月至2019年1月在青岛大学附属医院接受新辅助化疗后治疗的HB患儿的临床病历。
本研究共纳入21例患儿，其中男13例，女8例。所有病例均成功使用海信CAS对肝脏和肿瘤进行三维（3D）重建，模拟肝切除术，并根据术前手术计划进行肝切除术。右半肝切除术12例，右三叶肝切除术4例，左叶肝切除术1例，中叶肝切除术3例，Ⅴ和Ⅵ段肝切除术1例。所有患儿术后恢复良好。随访时间为5个月至3年。1例患儿术后8个月死于全身转移。1例患儿术后接受了1个疗程的化疗。由于化疗反应严重，家属拒绝进一步治疗和随访。其余19例患儿无并发症或复发。
海信CAS能清晰直观地显示化疗前后HB的位置、形态及其与肝内管道系统的关系，准确评估肿瘤体积变化及重要血管间距，有利于术者选择最佳手术时机，及时制定最佳手术方案，实施个体化精准肝肿瘤切除。
