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3D 打印模型对接受机器人辅助根治性前列腺切除术患者定量手术结果的影响:一项队列研究。

Impact of 3D printed models on quantitative surgical outcomes for patients undergoing robotic-assisted radical prostatectomy: a cohort study.

机构信息

GE HealthCare, New York, NY, USA.

Center for Advanced Imaging Innovation and Research (CAI²R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.

出版信息

Abdom Radiol (NY). 2023 Apr;48(4):1401-1408. doi: 10.1007/s00261-023-03815-2. Epub 2023 Feb 7.

Abstract

BACKGROUND

Three-dimensional (3D) printed anatomic models can facilitate presurgical planning by providing surgeons with detailed knowledge of the exact location of pertinent anatomical structures. Although 3D printed anatomic models have been shown to be useful for pre-operative planning, few studies have demonstrated how these models can influence quantitative surgical metrics.

OBJECTIVE

To prospectively assess whether patient-specific 3D printed prostate cancer models can improve quantitative surgical metrics in patients undergoing robotic-assisted radical prostatectomy (RARP).

METHODS

Patients with MRI-visible prostate cancer (PI-RADS V2 ≥ 3) scheduled to undergo RARP were prospectively enrolled in our IRB approved study (n = 82). Quantitative surgical metrics included the rate of positive surgical margins (PSMs), operative times, and blood loss. A qualitative Likert scale survey to assess understanding of anatomy and confidence regarding surgical approach was also implemented.

RESULTS

The rate of PSMs was lower for the 3D printed model group (8.11%) compared to that with imaging only (28.6%), p = 0.128. The 3D printed model group had a 9-min reduction in operating time (213 ± 42 min vs. 222 ± 47 min) and a 5 mL reduction in average blood loss (227 ± 148 mL vs. 232 ± 114 mL). Surgeon anatomical understanding and confidence improved after reviewing the 3D printed models (3.60 ± 0.74 to 4.20 ± 0.56, p = 0.62 and 3.86 ± 0.53 to 4.20 ± 0.56, p = 0.22).

CONCLUSIONS

3D printed prostate cancer models can positively impact quantitative patient outcomes such as PSMs, operative times, and blood loss in patients undergoing RARP.

摘要

背景

三维(3D)打印解剖模型可以通过向外科医生提供有关相关解剖结构的确切位置的详细知识,从而促进术前规划。尽管已经证明 3D 打印解剖模型对于术前计划很有用,但很少有研究表明这些模型如何影响定量手术指标。

目的

前瞻性评估患者特异性 3D 打印前列腺癌模型是否可以改善接受机器人辅助根治性前列腺切除术(RARP)的患者的定量手术指标。

方法

前瞻性地招募了 82 名接受 MRI 可见前列腺癌(PI-RADS V2≥3)且计划接受 RARP 的患者参加我们的 IRB 批准的研究。定量手术指标包括阳性手术边缘率(PSM)、手术时间和失血量。还实施了定性李克特量表调查,以评估对解剖结构的理解和对手术方法的信心。

结果

与仅使用影像学检查相比,3D 打印模型组的 PSM 率较低(8.11%比 28.6%,p=0.128)。3D 打印模型组的手术时间缩短了 9 分钟(213±42 分钟比 222±47 分钟),平均失血量减少了 5 毫升(227±148 毫升比 232±114 毫升)。在查看 3D 打印模型后,外科医生的解剖理解和信心得到了提高(3.60±0.74 至 4.20±0.56,p=0.62 和 3.86±0.53 至 4.20±0.56,p=0.22)。

结论

3D 打印前列腺癌模型可以对接受 RARP 的患者的定量患者结果(如 PSM、手术时间和失血量)产生积极影响。

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