混合现实技术在腹膜后肿瘤手术中的应用

Application of mixed reality technique in retroperitoneal tumor surgery

目的分析混合现实技术在腹膜后肿瘤手术中的临床疗效及应用价值。方法收集2018年9月至2020年7月就诊于骨与软组织外科的腹膜后肿瘤患者8例,其中男3例,女5例,年龄24~68(44.4±18.6)岁,肿瘤容积为83.3~1 351.6(699.9±493.8)ml,病程3~96(24.4±32.3)周。良性3例,恶性5例,包括神经鞘瘤1例,神经纤维瘤1例,炎性肌纤维母细胞瘤1例,骨外骨肉瘤1例,恶性神经鞘瘤2例,平滑肌肉瘤1例,脂肪肉瘤1例。应用混合现实技术对肿瘤的大小、毗邻关系、解剖位置结构进行分析,记录术中失血量和手术时间。结果 8例患者手术均顺利进行,手术时间80~280(165.0±67.3)min,术中失血量500~2 000(1 062.5±616.3)ml, 8例患者均按照预设手术方案及切除范围进行手术,所有肿瘤毗邻的血管神经均保护完好,无明显副损伤。全部病例获得随访,随访时间1~18(7.9±6.2)个月,随访期间内全部病例未发现肿瘤复发及转移。结论混合现实技术可作为腹膜后肿瘤术前设计、医患沟通及术中引导的辅助手段,避免损伤肿瘤毗邻的重要解剖结构。

Objective To analyze the clinical efficacy and application value of mixed reality technology in retroperitoneal tumor surgery.Methods Eight patients with retroperitoneal tumor treated from September 2018 to July 2020 were selected, including 3 males and 5 females with a mean age of(44.4±18.6)years old(ranging from 24 to 68).The tumor volume was 83.3 to 1 351.6(699.9±493.8) ml, and the course of disease was 3-96(24.4±32.3) weeks.Of 3 benign and 5 malignant tumors, there were 1 case of schwannoma, 1 case of neurofibroma, 1 case of inflammatory myofibroblastoma, 1 case of extraosseous osteosarcoma, 2 cases of malignant schwannomas, 1 case of leiomyosarcoma and 1 case of liposarcoma.Mixed reality technology was used to analyze tumor size, adjacent structure and anatomical location.The intraoperative blood loss and the operation time were recorded.Results The operation time was 80-280(165.0±67.3) min, and the intraoperative blood loss was 500-2 000(1 062.5±616.3) ml.All patients were successfully operated according to the preset operation flow.The blood vessels and nerves adjacent to the tumor were well protected without obvious evidence of damage.All patients were followed up for 1-18(7.9±6.2) months, and no tumor recurrence or metastasis was found in 8 cases.Conclusion For the patients with retroperitoneal tumors, mixed reality technology can be used as an auxiliary means for preoperative design, doctor-patient communication and intraoperative guidance to avoid damaging important anatomical structures adjacent to the tumor.