3D打印技术在精准切除治疗肝脏肿瘤中的应用
| 作者: |
1徐安书,
1傅朝春,
1韦萍,
2王峻峰,
1刘煜,
1付彪,
1张世博,
1邓大波,
1杨晓宾,
1陈会彬
1 昆明医科大学附属曲靖医院 普通外科二病区，云南 曲靖 655000 2 云南省第一人民医院 肝胆科，云南 昆明 650000 |
| 通讯: |
傅朝春
Email: 315000722@qq.com |
| DOI: | 10.3978/.2018.01.005 |
摘要
目的：探讨3D打印技术在肝脏肿瘤精准切除中的应用效果。
方法：将2016年5月—2017年5月收治的30例肝脏肿瘤患者随机分为对照组和观察组，每组各15例，其中对照组患者在CT影像资料上进行术前评估，拟定手术方案；观察组患者术前经CT检查后对影像资料进行肝脏3D重建，导入3D打印机，打印出1:0.6的肝脏物理模型，然后分析肝脏解剖、进行术前模拟，确定手术方案，比较两组患者的相关临床指标。
结果：两组患者术前资料具有可比性。与对照组比较，观察组平均手术时间（71 min vs. 83 min）、肝门阻断时间（50.1 min vs. 54.7 min）、估计出血量（103.9 mL vs. 121.2 mL）、住院时间（18.9 d vs. 20.4 d）均明显减少（均P<0.05），总并发症发生率（6.7% vs. 20.0%）明显降低（P<0.05），且肝功能指标方面也有明显优势（均P<0.05）。随访1~12个月，1例患者出现肺部转移，余患者均无进展生存。
结论：3D打印技术能有效帮助肝脏肿瘤患者进行精准治疗，提高手术成功率，降低手术并发症，利于患者的术后康复。
关键词：
肝肿瘤；肝切除术；打印，三维
方法：将2016年5月—2017年5月收治的30例肝脏肿瘤患者随机分为对照组和观察组，每组各15例，其中对照组患者在CT影像资料上进行术前评估，拟定手术方案；观察组患者术前经CT检查后对影像资料进行肝脏3D重建，导入3D打印机，打印出1:0.6的肝脏物理模型，然后分析肝脏解剖、进行术前模拟，确定手术方案，比较两组患者的相关临床指标。
结果：两组患者术前资料具有可比性。与对照组比较，观察组平均手术时间（71 min vs. 83 min）、肝门阻断时间（50.1 min vs. 54.7 min）、估计出血量（103.9 mL vs. 121.2 mL）、住院时间（18.9 d vs. 20.4 d）均明显减少（均P<0.05），总并发症发生率（6.7% vs. 20.0%）明显降低（P<0.05），且肝功能指标方面也有明显优势（均P<0.05）。随访1~12个月，1例患者出现肺部转移，余患者均无进展生存。
结论：3D打印技术能有效帮助肝脏肿瘤患者进行精准治疗，提高手术成功率，降低手术并发症，利于患者的术后康复。
Application of 3D printing technology in precision resection of liver tumors
CorrespondingAuthor:FU Chaochun Email: 315000722@qq.com
Abstract
Objective: To investigate the application efficacy of 3D printing technology in precision resection of liver tumors.
Methods: Thirty patients with liver tumors admitted from May 2016 to May 2017 were enrolled and randomly designated to control group and observation group, with 15 cases in each group. Patients in control group underwent preoperative assessment and surgical treatment plan decision-making based on the image data of CT examination, those in observation group received liver 3D reconstructions of the CT images, which were imported into the 3D printer to create a 1:0.6 liver physical model, and then underwent liver anatomical analysis, preoperative simulation, and surgical plan-making. The main clinical variables between the two groups of patients were compared.
Results: The preoperative data were comparable between the two groups of patients. In observation group compared with control group, the average operative time (71 min vs. 83 min), time of hepatic portal occlusion (50.1 min vs. 54.7 min), the estimated blood loss (103.9 mL vs. 121.2 mL), length of hospital stay (18.9 d vs. 20.4 d) were all significantly reduced (all P<0.05), the overall incidence of complications (6.7% vs. 20.0%) was significantly decreased (P<0.05), and all the liver function parameters showed superior values (all P<0.05). Follow-up was conducted for 1 month to 12 months, lung metastases occurred in one case, and progression-free survival was seen in all the remaining cases.
Conclusion: 3D printing technology can effectively help precision treatment in patients with liver tumors, improve the surgical success rates and reduce surgical complications, and thereby facilitate the postoperative recovery of the patients.
Keywords：
Liver Neoplasms; Hepatectomy; Printing
Three-Dimensional
Methods: Thirty patients with liver tumors admitted from May 2016 to May 2017 were enrolled and randomly designated to control group and observation group, with 15 cases in each group. Patients in control group underwent preoperative assessment and surgical treatment plan decision-making based on the image data of CT examination, those in observation group received liver 3D reconstructions of the CT images, which were imported into the 3D printer to create a 1:0.6 liver physical model, and then underwent liver anatomical analysis, preoperative simulation, and surgical plan-making. The main clinical variables between the two groups of patients were compared.
Results: The preoperative data were comparable between the two groups of patients. In observation group compared with control group, the average operative time (71 min vs. 83 min), time of hepatic portal occlusion (50.1 min vs. 54.7 min), the estimated blood loss (103.9 mL vs. 121.2 mL), length of hospital stay (18.9 d vs. 20.4 d) were all significantly reduced (all P<0.05), the overall incidence of complications (6.7% vs. 20.0%) was significantly decreased (P<0.05), and all the liver function parameters showed superior values (all P<0.05). Follow-up was conducted for 1 month to 12 months, lung metastases occurred in one case, and progression-free survival was seen in all the remaining cases.
Conclusion: 3D printing technology can effectively help precision treatment in patients with liver tumors, improve the surgical success rates and reduce surgical complications, and thereby facilitate the postoperative recovery of the patients.