混合现实辅助后腹腔镜下肾肿瘤手术可行性与安全性研究

Feasibility and safety study of mixed reality assisted laparoscopic renal tumor surgery

目的探讨应用混合现实(MR)技术协助后腹腔镜肾肿瘤手术的可行性、安全性及实用性。方法选取2018年3月至2020年3月中国医科大学附属盛京医院泌尿外科拟行后腹腔镜肾肿瘤手术患者180例,随机数字表法分为MR辅助组(MR组)90例和未行MR辅助组90例(未行MR组)。MR组由9名泌尿外科医师应用MR技术辅助完成后腹腔镜手术,术者分别使用CT片和MR成像向患者及家属陈述病情并讲解手术方案,患者于前后两次回答手术相关问题,评估其疾病相关知识掌握情况。实用性评估参照9名医生的问卷调查。安全性评估使用了Clavien-Dindo并发症分级系统,随访1个月。结果MR组相比未行MR组,手术时间、热缺血时间缩短,出血量减少,差异有统计学意义(P<0.05)。应用MR进行医患术前交流、交代病情后90例患者对肾生理功能、肾解剖、手术方案的认知程度较交代病情前显著提高(P<0.05)。医师对MR技术应用的总体满意度高,67%的医师评价实用性为“十分有用”。结论MR技术辅助后腹腔镜下肾肿瘤微创术,能够易化医患沟通,减短手术时间,减少手术并发症,是一种安全可行的辅微创手术技术。

Objective To investigate the feasibility,safety and practicality of mixed reality(MR)technology in assisting retroperitoneal laparoscopic renal tumor surgery.Methods From March 2018 to March 2020,180 patients from the department of urology who underwent retroperitoneal renal tumor surgery were divided into MR group(n=90)and control group(n=90)by method of random number table.MR technology was performed by nine urologists in MR group to assist the completion of retroperitoneal laparoscopic surgery.CT and MR imaging were used to explain the condition and surgical plan.The mastery of disease-related knowledge was assessed before and after the surgery by patients.The Clavien-Dindo complication classification system was used to assessed the safety.Results Compared with the patients in control group,the patients in MR group had shorter length of operation time and hot ischemia time,less blood loss as well.The difference was statistically significant(P<0.05).The awareness of renal physiological function,renal anatomy,and surgical plan was significantly higher than that before the explanation of the condition(P<0.05).Overall satisfaction of physicians with the application of MR technology was improved.And 67%of physicians rated it as“very useful”for practicality.Conclusions The MR technology-assisted retroperitoneoscopic minimally invasive renal tumor surgery can facilitate doctor-patient communication,shorten operation time and reduce surgical complications,which is a safe and feasible assisted minimally invasive surgical technique.