基于CT影像的三维重建成像技术在腹腔镜大肾上腺肿瘤切除术中的应用

3D reconstruction imaging based on CT images in application of laparoscopic adrenalectomy for large adrenal tumor

目的探讨螺旋CT影像的三维重建成像技术在腹腔镜巨大肾上腺肿瘤切除术中的应用价值。方法对内蒙古自治区人民医院2019年6月至2021年8月12例肾上腺巨大肿瘤患者进行回顾性分析,患者平均年龄(46±14)岁,瘤体中位直径为7.40(6.72,8.27)cm,所有患者术前根据增强CT进行医学三维影像数据处理,后期进行分析并三维重建,术前充分准备后,腹腔镜经腹膜后切除9例,腹腔镜经腹切除3例。结果术中发现12例肿瘤均位于腹膜后,左侧3例,右侧9例,术前三维成像与术中情况一致,12例患者手术顺利,手术时间(168±19)min,术中中位出血量105(80,167)ml,无重要脏器及大血管等副损伤,无转开放手术病例。结论对于腹膜后肾上腺巨大肿瘤,采用螺旋CT三维重建成像,使术者能在术前充分认识肿瘤与周围脏器及血管的关系,可以减少术中出血及副损伤,提高腹腔镜下切除成功率,进而提高手术安全性。

ObjectiveTo explore the application value of 3D reconstruction imaging based on CT images in laparoscopic adrenalectomy for large adrenal tumors.MethodsA retrospective analysis was performed on 12 patients with large adrenal tumor from June 2019 to August 2021 in Inner Mongolia Autonomous Region People's Hospital. The mean age of patients was (46±14) years old, and the median tumor diameter was 7.40(6.72, 8.27) cm. All patients underwent post-analysis and 3D reconstruction according to enhanced CT medical 3D image data processing software. After preoperative preparation, laparoscopic retroperitoneal resection was performed in 9 cases and laparoscopic transperitoneal resection in 3 cases.Results12 cases of tumors were found to be located in retroperitoneum during operation, including 3 cases on the left side and 9 cases on the right side. The spiral CT 3D imaging was consistent with the intraoperative situation. All 12 patients underwent operation, the mean operative time was (168±19) min, the median intraoperative blood loss was 105(80, 167) ml, no accessory injury of important organs or large vessels, and no conversion to open surgery.ConclusionsFor large retroperitoneal tumors, spiral CT 3D imaging can make surgeons fully understand the relationship between tumors and surrounding organs and blood vessels, reduce intraoperative bleeding and accessory injury, improve the success rate of laparoscopic resection and the safety of surgery.