Meershoek Armelle J A, Loonen Tom G J, Maal Thomas J J, Hekma Edo J, Hugen Niek
Department of Surgery, Rijnstate, Arnhem, the Netherlands.
3D Lab, Radboud University Medical Center, Nijmegen, The Netherlands.
Med Sci Educ. 2023 Jun 9;33(4):873-878. doi: 10.1007/s40670-023-01807-x. eCollection 2023 Aug.
Pulmonary anatomy is challenging, due to the high variability and its three-dimensional (3D) shape. While demands in thoracic oncologic surgery are increasing, the transition from open to thoracoscopic surgery is hampering anatomical understanding. This study analyzed the value of a 3D printed lung model in understanding and teaching anatomy.
A 3D pulmonary model was created and tested among different levels of proficiency: 10 experienced surgeons, 10 fellow surgeons and 10 junior residents. They were tested in interpretation of anatomy based on thoracic CT-scans, either using the 3D model or a 2D anatomical atlas. Accuracy of the given answers, time to complete the task and the self-reported level of certainty were scored in each group.
In the experienced surgeons group there was no difference in between the 2D-model or 3D-model with a high rate of correct answers in both groups, and no differences in time or certainty. Fellow surgeons highly benefitted from the 3D-model with an improved accuracy from 26.6% to 70.0% (p = 0.001). Time to complete the task was shorter (207 versus 122 s, p < 0.0001) and participants were more secure (median of 4 versus 3, p = 0.007). For junior residents time to complete the task was shorter, the level of certainty was higher, but there was no improvement in accuracy.
3D printing may benefit in understanding anatomical relations in the complex anatomy of the bronchiopulmonary tree, especially for surgeons in training and could benefit in teaching anatomy.
The online version contains supplementary material available at 10.1007/s40670-023-01807-x.
由于肺部解剖结构高度可变且呈三维（3D）形态，其解剖颇具挑战性。随着胸科肿瘤手术需求的增加，从开放手术向胸腔镜手术的转变妨碍了解剖结构的理解。本研究分析了3D打印肺模型在解剖结构理解和教学中的价值。
创建一个3D肺模型，并在不同熟练程度的人群中进行测试：10名经验丰富的外科医生、10名住院医师和10名低年资住院医生。他们基于胸部CT扫描，使用3D模型或二维解剖图谱对解剖结构进行解读测试。对每组给出答案的准确性、完成任务的时间和自我报告的确定程度进行评分。
在经验丰富的外科医生组中，二维模型和3D模型之间没有差异，两组的正确答案率都很高，在时间或确定程度上也没有差异。住院医师从3D模型中受益匪浅，准确率从26.6%提高到70.0%（p = 0.001）。完成任务的时间更短（207秒对122秒，p < 0.0001），参与者更有把握（中位数为4对3，p = 0.007）。对于低年资住院医生来说，完成任务的时间更短，确定程度更高，但准确率没有提高。
3D打印可能有助于理解支气管肺树复杂解剖结构中的解剖关系,特别是对于正在接受培训的外科医生，并且在解剖教学中可能会有所帮助。
在线版本包含可在10.1007/s40670-023-01807-x获取的补充材料。
