摘要
目的探讨腹部医学图像三维可视化系统(MI-3DVS)在复杂性肝切除中的诊疗价值。方法因肝癌或肝脏局灶性结节增生而行复杂性肝切除术者共24人,利用MI-3DVS三维重建肝脏、肿瘤、血管等,术前行仿真手术,明确手术可行性;统计分析肿瘤直径、术中出血量、输血量、并发症、住院死亡率及1年生存率等。结果所有患者都安全并成功实施了肝切除术,无围手术期死亡。肝肿瘤直径(9.8±4.3)cm,术中出血量和输血量中位数分别为800和600 ml,输血率91.7%(22/24),住院死亡率0,并发症发生率29.2%(7/24),1年生存率37.5%。结论肝脏容积分析法、剩余肝血流障碍风险评估等3D技术可增加复杂性肝切除手术规划的准确率及手术安全性。
Objective To assess the value of abdominal three-dimensional medical image visualization system (MI-3DVS) in assisting complicated hepatectomy. Methods Twenty-four patients undergoing complicated hepatectomy for hepatic carcinoma or hepatic focal nodular hyperplasia were enrolled in this study. Three-dimensional models of the organs, vessels and tumors were reconstructed with MI-3DVS, and virtual operations were carried out to assess the feasibility of hepatectomy. The diameter of the liver tumors, intraoperative blood loss and transfusion, complications, in-hospital mortality rate, and one-year survival rate were analyzed in these cases. Results The operations were safely completed in all the cases without perioperative deaths. The mean diameter of liver tumor was 9.8±4.3 cm, and the median volumes of intraoperative blood loss and transfusion were 800 ml and 600 ml, respectively, with a blood transfusion rate of 91.7% (22/24). The incidence of complications was 29.2% (7/24), and the one-year survival rate was 37.5%. Conclusion Three-dimensional techniques such as volumetric analysis and risk evaluation of residual liver blood supply and drainage can increase the accuracy of surgical planning and improve the safety of complicated hepatectomy.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2012年第8期1116-1121,共6页
Journal of Southern Medical University
基金
国家863科学基金项目(2006AA02Z346)
国家自然科学基金(30470493)
广东省自然科学基金团队项目(6200171)
广东省中科院全面战略协作项目(20100904)
广东省教育部产学研结合项目(2009B080701077)~~
关键词
复杂性肝切除
三维重建
仿真手术
体积
手术规划
并发症
complicated hepatectomy
three-dimensional reconstruction
virtual operation
volume
operation planning
complications