Shan Yibo, Yu Guiping, Lu Yi, Kong Hao, Jiang Xuewei, Shen Zhiming, Sun Fei, Shi Hongcan
Clinical Medical College, Yangzhou University, Yangzhou 225000, China.
Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou 225000, China.
Ann Thorac Med. 2022 Jul-Sep;17(3):173-179. doi: 10.4103/atm.atm_506_21. Epub 2022 Jul 9.
To explore the clinical value of three-dimensional (3D) reconstruction technology combined with 3D printing in the treatment of pectus excavatum (PE).
The clinical data of 10 patients with PE in our department from June 2018 to December 2020 were analyzed retrospectively. All patients underwent thin-layer computed tomography examination before the operation, and then 3D reconstruction was performed with Mimics 20.0 software. The radian and curvature of the pectus bar were designed according to the reconstructed images. Afterward, the images were imported into the light-curing 3D printer in STL format for slice printing. Hence that the personalized operation scheme, including the size of the pectus bar and the surgical approach, can be made according to the 3D printed model. The thoracoscopic-assisted Nuss operation was completed by bilateral incisions. The operation time, intraoperative blood loss, and postoperative hospitalization were counted and analyzed. The satisfaction of the surgery was evaluated according to the Haller index and the most posterior sternal compression sternovertebral distance.
The surgeries were successfully completed in 10 patients without a transfer to open procedure. The average operation time was (56 ± 8.76) min, the intraoperative blood loss was (23.5 ± 11.07) mL, and the postoperative hospitalization was (7.2 ± 0.92) d. There were no serious complications or death during the perioperative period. Compared with the data before the operation, the most posterior sternal compression sternovertebral distance was larger, and the Haller index was lower, the differences were statistically significant ( < 0.05).
3D reconstruction technology combined with 3D printing, which can be used before operation, contributes to the operator performing thoracoscopic-assisted Nuss operation safely and effectively, which has productive clinical application value for the treatment of pectus excavatum.
探讨三维（3D）重建技术联合3D打印在漏斗胸（PE）治疗中的临床价值。
回顾性分析2018年6月至2020年12月我科收治的10例漏斗胸患者的临床资料。所有患者术前均行薄层计算机断层扫描检查，然后用Mimics 20.0软件进行3D重建。根据重建图像设计鸡胸矫正条的弧度和曲率。之后，将图像以STL格式导入光固化3D打印机进行切片打印。从而可以根据3D打印模型制定个性化的手术方案，包括鸡胸矫正条的尺寸和手术入路。通过双侧切口完成胸腔镜辅助下的Nuss手术。统计并分析手术时间、术中出血量和术后住院时间。根据Haller指数和胸骨后缘最凹陷处胸骨与椎体的距离评估手术满意度。
10例患者均成功完成手术，无需转为开放手术。平均手术时间为（56±8.76）分钟，术中出血量为（23.5±11.07）毫升，术后住院时间为（7.2±0.92）天。围手术期无严重并发症或死亡。与术前数据相比，胸骨后缘最凹陷处胸骨与椎体的距离增大，Haller指数降低，差异有统计学意义（<0.05）。
术前应用3D重建技术联合3D打印有助于术者安全有效地实施胸腔镜辅助下的Nuss手术，对漏斗胸的治疗具有较高的临床应用价值。
