三维重建结合3D打印技术在腔镜甲状腺手术中的临床应用

The clinical application of three dimension reconstruction and 3D printing technology in endoscopic thyroid surgery

目的:探讨三维重建结合3D打印技术在腔镜甲状腺手术中的临床应用。方法:回顾分析125例经胸乳入路腔镜甲状腺切除术的临床资料,其中116例行常规腔镜甲状腺手术(A组);9例应用强化CT三维重建结合3D打印技术行腔镜甲状腺手术(B组)。结果:两组手术均获成功,无一例中转开放,均未损伤喉返神经及甲状旁腺。B组较A组手术时间短,出血减少,与患者沟通更容易,两组相比差异有统计学意义(P<0.05);术后并发症发生率及随访患者满意度两组相比差异无统计学意义(P>0.05)。结论:两种术式的美容优势均较明显,将三维重建结合3D打印技术应用于腔镜甲状腺手术前手术预演、精准诊疗及与患者沟通等方面,可减少手术及与患者沟通的时间、术中出血量,降低手术难度,提高手术安全性,具有较广阔的应用前景。

Objective： To investigate the clinical application of three dimension reconstruction and 3D printing technology in endoscopic thyroid surgery. Methods： A retrospective analysis of 125 patients who underwent endoscopic thyroidectomy via anterior chest approach was performed. Among them,116 patients underwent conventional endoscopic thyroid surgery（ group A）,enhancement CT three-dimensional reconstruction and 3D printing technology was used in the other 9 patients before endoscopic thyroid surgery（ group B）. Results： Laparoscopic surgery was performed successfully in both groups,without conversion to open surgery or injury of recurrent laryngeal nerve and parathyroid glands. The operative time of group B was shorter than that of group A（ P〈0. 05）,and blood loss was much less（ P 0. 05）. In addition,the patients of group B were easier to communicate（ P 0. 05）. There were no statistically significant differences between the two groups regarding postoperative complications and patient＇s satisfaction（ P 0. 05）. Conclusions： The cosmetic advantage of endoscopic thyroidectomy is evident. The application of three dimension reconstruction and 3D printing technology in surgery rehearse before endoscopic thyroid surgery not only contributes to preoperative accurate diagnosis,treatment and communication,but also reduces time of operation and communication,blood loss during surgery and difficulty of operation. This technology improves operative safety and has broad application prospects.