Yuan Xiaobin, Liu Xiaolei, Jing Qiang, Liu Fan, Zhang Xuhui
Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
First College of Clinical Medicine, Shanxi Medical University, No. 56, Xinjiannan Road, Taiyuan, 030001, Shanxi, China.
Perioper Med (Lond). 2022 Jun 28;11(1):22. doi: 10.1186/s13741-022-00256-1.
In this study, it was aimed to evaluate the feasibility and effectiveness of full-size three-dimensional individual printed model (3D-IPM) based on computerized tomography (CT) reconstruction combined with 3D individual digital models (3D-IDMs) for improving the patient's and their families' comprehension levels of robotic-assisted laparoscopic partial nephrectomy (RALPN) preoperatively.
Between January 2020 and January 2021, 37 patients underwent RALPN in our institution. 3D individual digital models (3D-IDMs) were reconstructed based on the data of computerized tomography (CT) scanning and full-size 3D-IPMs were fabricated correspondingly. For each patient and his/her closest accompanying immediate family member (CAIFM) (spouse or son/daughter), two semi-structured conversations were held by using CT films (1st conversation) and 3D-IPM combined with 3D-IDM demonstration (2nd one) respectively. The preoperative levels of comprehension were evaluated quantitatively by using a self-made preoperative comprehending score (PCS) in the patients and CAIFMs.
All the fabrications of full-size 3D-IPMs and all the operations were technically successful. The total PCS elevated significantly by presenting 3D-IPM combined with 3D-IDM demonstration compared with CT films (42.5 vs 35.5 in patients, P < 0.001; 42.9 vs 35.8 in CAIFMs, P < 0.001). Sub-PCSs in the evaluating aspects of renal anatomy, mass characteristics, the upcoming RALPN procedure, potential complication risks, and prognosis also showed a uniformed climbing pattern with the assistance of 3D-IPM+3D-IDM.
The application of 3D-IPM presentation combined with 3D-IDM demonstration can improve the preoperative comprehension of patient and CAIFM to RALPN with more direct-viewing and verisimilar presentation, and can be used in RALPN patient education for increasing patients' and their families' cognitive empowerment.
本研究旨在评估基于计算机断层扫描(CT)重建的全尺寸三维个体化打印模型(3D-IPM)结合三维个体化数字模型(3D-IDM),在术前提高患者及其家属对机器人辅助腹腔镜部分肾切除术(RALPN)理解水平的可行性和有效性。
2020年1月至2021年1月期间,我院37例患者接受了RALPN手术。基于计算机断层扫描(CT)扫描数据重建三维个体化数字模型(3D-IDM),并相应制作全尺寸3D-IPM。对于每位患者及其最亲密的直系家属(CAIFM)(配偶或子女),分别使用CT片(第一次谈话)和3D-IPM结合3D-IDM演示(第二次谈话)进行两次半结构化谈话。通过使用自制的术前理解评分(PCS)对患者和CAIFM的术前理解水平进行定量评估。
所有全尺寸3D-IPM的制作和所有手术在技术上均获成功。与CT片相比,3D-IPM结合3D-IDM演示使总PCS显著提高(患者:42.5对35.5,P<0.001;CAIFM:42.9对35.8,P<0.001)。在肾脏解剖、肿块特征、即将进行的RALPN手术、潜在并发症风险和预后等评估方面的子PCS在3D-IPM+3D-IDM的辅助下也呈现出一致的上升趋势。
3D-IPM展示结合3D-IDM演示的应用,能够以更直观、逼真的呈现方式提高患者和CAIFM对RALPN的术前理解,可用于RALPN患者教育,增强患者及其家属的认知能力。