计算机辅助三维定量分析及模拟手术设计系统在精准肝切除中的应用

Application of Computer-Assisted 3-Dimensional Quantitative Assessment and Virtual Surgical System in Precise Hepatectomy

目的:探讨计算机辅助三维定量分析及模拟手术设计系统在精准肝切除中的应用。方法:应用IQQA肝脏CT影像解读分析系统对17例拟行精确肝切除的患者进行肝脏三维重建,精确定位肝脏肿瘤并明确肿瘤与血管的解剖关系,计算全肝体积、拟切除肝脏体积、剩余肝脏体积,计算剩余肝脏体积与标准化全肝体积的比值(RSLVR),并据此设计手术方案。结果:17例患者的全肝体积平均为(1744.5±881.6)cm3,拟切除肝体积平均为(919.2±884.4)cm3,剩余肝体积平均为(825.3±228.6)cm3,RSLVR平均为(67.6±22.3)%。所有患者均行解剖性肝切除,手术过程顺利,术后并发症包括胆漏1例,胸腔积液6例,中等量以上腹水4例,肺感染1例。结论:计算机辅助三维定量分析及模拟手术设计系统可精确定位肝脏肿瘤,并辅助设计最优化的手术方案。

Objective： To assess the effect of computer-assisted 3-dimensional quantitative assessment and virtual sur- gical system for precise hepatectomy. Methods： The clinical data of 17 patients who had undergone precise hepatectomy were retrospectively analyzed. EDDA＇ s IQQA-Liver was used for the constructed 3-dimensional imaging of liver. The ana- tomic relationship between hepatic vessel and tumor was analyzed. The total liver volume, predicted resection volume, the remnant liver volume and remnant-standard liver volume ratio （RSLVR） were calculated, and then the operative program was planned. Results： The mean value of total liver volume was（1 744.5±881.6） cm^3, the predicted resection volume was （919.2± 884.4） cm^3. The remnant liver volume was （825.3±228.6） cm^3, and RSLVR was （67.6±22.3） % in 17 patients. All patients received anatomical hepatectomy. The postoperative complications included 1 case of bile leak, 6 of pleural effusion, 4 of moderate or massive ascites and 1 of pulmonary infection. Conclusion： The computer-assisted 3-dimensional quantitative assess- ment and virtual surgical system helped to determine the tumor localization and to plan optimal liver resection operation.