基于三维重建的腹腔镜下胃癌根治术临床效果

To explore the clinical effect of Three-Dimensional reconstruction model in laparoscopic gastrectomy for gastric cancer

目的探讨三维重建模型在腹腔镜下胃癌根治术(LAG)中的临床效果。方法采用随机数字表法将2018年6月至2019年12月间行LAG的84例胃癌患者分为三维组(n=42)和CT组(n=42)。CT组使用CT图像进行术前规划和术中应用,三维组依据CT数据采用Mimics 17.0软件进行患者三维腹腔血管重建,利用三维模型进行术前规划和术中应用。采用SPSS18.0软件进行统计学分析。围术期相关指标等计量资料以(±s)表示,采用独立t检验;术后并发症等计数资料采用χ^(2)检验分析;以P<0.05表示差异有统计学意义。结果与CT组相比,三维组可明显缩短腹腔镜下胃癌根治术的手术时间、平均住院时间,减少术中出血量及术中输血,增加术中清除淋巴结个数,差异均具统计学意义(P<0.05)。而两组术后首次排气时间、术后并发症发生率差异均无统计学意义(P>0.05)。结论三维腹腔血管重建技术应用于LAG术中准确评估患者腹腔血管的分型及变异情况,在术中提供重要决策作用,具有明显优势,值得临床推广。

Objective To explore the clinical effect of three-dimensional reconstruction model in laparoscopic gastrectomy.Methods 84 cases of gastric cancer with LAG from June 2018 to June 2019 treated in our hospital were divided into 3D group(n=42)and CT group(n=42)by adopting the method of random number table.The CT group used CT images for preoperative planning and intraoperative application.Adopting MICs 17.0 software to reconstruct three-dimensional celiac blood vessels according to CT data,the 3D group used three-dimensional models for preoperative planning and intraoperative application.SPSS18.0 software was used for statistical analysis.The measurement data,such as relevant indicators in perioperative period,were expressed as and analyzed by independent sample t test.The enumeration data such as postoperative complications were expressed as%and analyzed byχ^(2)test.Indicating difference by P<0.05 was considered statistically significant.Results Compared with the CT group,the 3D group can apparently shorten the operation time and average hospitalization time of laparoscopic gastrectomy,reducing the amount of intraoperative bleeding and intraoperative blood transfusion,and increasing the number of lymph nodes removed during the operation.The above differences are statistically significant(P<0.05).However,the differences between the two groups in first postoperative exhaust time and the incidence of postoperative complications are of no statistical significance(P>0.05).Conclusion Three dimensional reconstruction of celiac blood vessels applying to laparoscopic radical gastrectomy can accurately evaluate the classification and variation of patients'celiac blood vessels,which can provide important decision-making role during the operation.It has obvious advantages and is worthy of clinical promotion.