Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
National Center for Tumor Diseases (NCT/UCC), Dresden, Germany.
Surg Endosc. 2023 Jun;37(6):4545-4554. doi: 10.1007/s00464-023-09915-w. Epub 2023 Feb 27.
Hepatobiliary surgery bares obstacles to informed consent for the patients due to its complexity and related risk of postoperative complications. 3D visualization of the liver has been proven to facilitate comprehension of the spatial relationship between anatomical structures and to assist in clinical decision-making. Our objective is to utilize individual 3D-printed liver models to enhance patient satisfaction with surgical education in hepatobiliary surgery.
DESIGN, SETTING: We conducted a prospective, randomized pilot study comparing 3D liver model-enhanced (3D-LiMo) surgical education against regular patient education during preoperative consultation at the department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Dresden, Germany.
Of 97 screened patients, undergoing hepatobiliary surgery, 40 patients were enrolled from July 2020 to January 2022.
The study population (n = 40) was predominantly of male gender (62.5%) with a median age of 65.2 years and a high prevalence of preexisting diseases. Underlying disease, warranting hepatobiliary surgery, was malignancy in the majority of cases (97.5%). Patients in the 3D-LiMo group were more likely to feel very thoroughly educated and exhibited a higher level of satisfaction following surgical education than the control group (80 vs. 55%, n.s.; 90 vs. 65%, n.s.; respectively). Applying 3D models was also associated with enhanced understanding of the underlying disease with regard to amount (100% vs. 70%, p = 0.020) and location of liver masses (95 vs. 65%, p = 0.044). 3D-LiMo patients also demonstrated enhanced understanding of the surgical procedure (80 vs. 55%, n.s.), leading to better awareness for the occurrence of postoperative complications (88.9, vs. 68.4%, p = 0.052). Adverse event profiles were similar.
In conclusion, individual 3D-printed liver models increase patient satisfaction with surgical education and facilitate patients' understanding of the surgical procedure as well as awareness of postoperative complications. Therefore, the study protocol is feasible to apply to an adequately powered, multicenter, randomized clinical trial with minor modifications.
由于肝胆外科手术的复杂性和术后并发症的相关风险，患者知情同意存在障碍。肝脏的 3D 可视化已被证明有助于理解解剖结构之间的空间关系，并有助于临床决策。我们的目标是利用个体化 3D 打印肝脏模型提高肝胆外科手术患者对手术教育的满意度。
设计、设置：我们进行了一项前瞻性、随机试点研究，比较了在德国德累斯顿卡尔古斯塔夫卡鲁斯大学医院内脏、胸部和血管外科进行术前咨询时，使用个体化 3D 打印肝脏模型（3D-LiMo）增强的手术教育与常规患者教育对患者的影响。
在筛选的 97 名接受肝胆外科手术的患者中，2020 年 7 月至 2022 年 1 月期间共有 40 名患者入组。
研究人群（n=40）主要为男性（62.5%），中位年龄为 65.2 岁，且普遍患有既往疾病。肝胆外科手术的主要原因是恶性肿瘤（97.5%）。与对照组相比，3D-LiMo 组患者在手术教育后更有可能感到自己受到了非常彻底的教育，并且满意度更高（80 比 55%，n.s.；90 比 65%，n.s.）。应用 3D 模型还与提高对疾病的理解程度有关，包括肝脏肿块的数量（100%比 70%，p=0.020）和位置（95%比 65%，p=0.044）。3D-LiMo 组患者对手术过程的理解也有所增强（80 比 55%，n.s.），这导致他们对术后并发症的发生有了更好的认识（88.9%比 68.4%，p=0.052）。不良事件谱相似。
总之，个体化 3D 打印肝脏模型提高了患者对手术教育的满意度，有助于患者理解手术过程以及对术后并发症的认识。因此，研究方案在进行适当的调整后可应用于多中心、随机临床试验。
