3D Slicer辅助神经内镜经鼻蝶入路鞍区肿瘤切除手术的应用研究

Application of 3D Slicer-assisted endoscopic transsphenoidal approach in sellar tumor resection

目的评估运用3D Slicer软件辅助功能在神经内镜经鼻蝶切除鞍区肿瘤手术的意义和价值。方法分析粤北人民医院2018年7月—2021年7月收治的60例鞍区肿瘤手术治疗患者临床资料,根据是否应用3D Slicer软件辅助功能分为观察组(应用3D软件辅助,n=30)和对照组(单纯神经内镜经鼻蝶入路手术,n=30)。比较两组之间手术时间、术中出血量、肿瘤全切除率,比较视野缺损和激素水平改善情况以及术后并发症等。结果全部患者均安全完成手术,术后无严重合并症发生。观察组在术中出血量、手术时长方面以及降低海绵间窦损伤、脑脊液漏的发生方面均优于对照组(P<0.05)。术后的内分泌激素改善及视野缺损改善,观察组优于对照组(P<0.05)。结论3D Slicer软件辅助神经内镜经鼻蝶入路切除鞍区肿瘤能做到高精度术前规划,有利于缩短手术时间,有助于减少术后并发症的发生。

Objective To investigate the significance and value of 3D Slicer software in assisting endoscopic transsphenoidal resection of sellar tumors.Methods A retrospective analysis was performed for the clinical data of 60 patients with sellar tumors who underwent endoscopic transsphenoidal surgery in Yuebei People’s Hospital from July 2018 to July 2021,and according to whether 3D Slicer software was used for assistance,they were divided into observation group with 30 patients assisted by 3D software and control group with 30 patients receiving endoscopic transsphenoidal surgery alone.The two groups were compared in terms of time of operation,intraoperative blood loss,total tumor resection rate,improvement in visual field defect and hormone levels,and postoperative complications.Results All patients underwent the surgery safely,with no serious complications after surgery.The observation group had better outcomes than the control group in terms of intraoperative blood loss,time of operation,and the incidence rates of intercavernous sinus injury and cerebrospinal fluid leak(P<0.05).Compared with the control group,the observation group had significantly better improvements in hormones and visual field defect after surgery(P<0.05).Conclusions 3D Slicer-assisted endoscopic transsphenoidal resection of sellar tumors can achieve high-precision preoperative planning,which may help to shorten the time of operation and reduce the incidence rates of postoperative complications.