Chambers Aidan, Traverson Marine, Neal Shelby, Konala Satyanarayana, Harrysson Ola
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States.
Center for Additive Manufacturing and Logistics, College of Engineering, North Carolina State University, Raleigh, NC, United States.
Front Vet Sci. 2023 Jun 8;10:1127025. doi: 10.3389/fvets.2023.1127025. eCollection 2023.
Caudal maxillectomies are challenging procedures for most veterinary surgeons. Custom guides may allow the procedure to become more accessible.
A cadaveric study was performed to evaluate the accuracy and efficiency of stereolithography guided (3D-printed) caudal maxillectomy. Mean absolute linear deviation from planned to performed cuts and mean procedure duration were compared pairwise between three study groups, with 10 canine cadaver head sides per group: 3D-printed guided caudal maxillectomy performed by an experienced surgeon (ESG) and a novice surgery resident (NSG), and freehand procedure performed by an experienced surgeon (ESF).
Accuracy was systematically higher for ESG versus ESF, and statistically significant for 4 of 5 osteotomies ( < 0.05). There was no statistical difference in accuracy between ESG and NSG. The highest absolute mean linear deviation for ESG was <2 mm and >5 mm for ESF. Procedure duration was statistically significantly longer for ESG than ESF ( < 0.001), and for NSG than ESG ( < 0.001).
Surgical accuracy of canine caudal maxillectomy was improved with the use of our novel custom cutting guide, despite a longer duration procedure. Improved accuracy obtained with the use of the custom cutting guide could prove beneficial in achieving complete oncologic margins. The time increase might be acceptable if hemorrhage can be adequately controlled . Further development in custom guides may improve the overall efficacy of the procedure.
对于大多数兽医外科医生来说,上颌骨尾侧切除术是具有挑战性的手术。定制导板可能会使该手术更容易实施。
进行了一项尸体研究,以评估立体光刻引导(3D打印)的上颌骨尾侧切除术的准确性和效率。在三个研究组之间两两比较从计划切口到实际切口的平均绝对线性偏差和平均手术持续时间,每组有10个犬类尸体头部侧面:由经验丰富的外科医生进行的3D打印引导的上颌骨尾侧切除术(ESG)和新手住院医生进行的(NSG),以及由经验丰富的外科医生进行的徒手手术(ESF)。
ESG组的准确性系统地高于ESF组,并且在5处截骨中有4处具有统计学显著性差异(<0.05)。ESG组和NSG组在准确性上没有统计学差异。ESG组的最高绝对平均线性偏差<2毫米,而ESF组>5毫米。ESG组的手术持续时间在统计学上显著长于ESF组(<0.001),NSG组的手术持续时间显著长于ESG组(<0.001)。
尽管手术持续时间较长,但使用我们新型的定制切割导板提高了犬上颌骨尾侧切除术的手术准确性。使用定制切割导板获得的更高准确性可能有助于实现完整的肿瘤切缘。如果出血能够得到充分控制,时间增加可能是可以接受的。定制导板的进一步发展可能会提高该手术的整体效果。