中国实用外科杂志

中国实用外科杂志

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三维可视化技术在复杂性肝癌切除术中应用研究

陈昭硕，周    东，许少华，张    帆，张明基   

  1. 福建省肿瘤医院  福建医科大学附属肿瘤医院，福建福州350014
  • 出版日期:2021-06-01 发布日期:2021-06-10

  • Online:2021-06-01 Published:2021-06-10

摘要： 目的    探讨三维可视化技术在复杂性肝癌切除术中的临床应用价值。方法    回顾性分析2019年3月至2020年3月福建医科大学附属肿瘤医院肝胆胰外科收治的23例复杂型肝癌病人资料，运用三维可视化技术重建肝脏三维模型行虚拟肝切除，进行手术的病人比较虚拟肝切除体积与实际肝切除体积的差别，并观察病人术后并发症发生的情况。结果    23 例病人中20例完成了手术治疗。术中均未损伤重要血管，术后均未出现出血、肝功能衰竭等严重并发症，手术病人均康复出院。病人虚拟肝切除体积与实际切除体积比较，差异无统计学意义（t=0.447，P＞0.05），相关性分析显示成正相关（r=0.982，P＜0.01）。结论    三维可视化技术具有清晰显示肝内脉管系统及其与肿瘤的毗邻关系、计算残肝体积、最优化模拟手术路径、协助医患术前沟通等优点，临床应用于复杂性肝癌，有助于预判手术风险，制定个体化的手术方案，降低术后并发症发生率。

关键词: 复杂性肝癌, 三维可视化技术, 精准肝切除

Abstract: Application of three-dimensional visualization in hepatectomy of complex hepatocellular carcinoma: A report of 23 cases        CHEN Zhao-shuo*, ZHOU Dong, XU Shao-hua, et al. *Fujian Provincial Tumor Hospital, the Affiliated Tumor Hospital of Fujian Medical University, Fuzhou 350014，China
Corresponding author：ZHOU Dong, E-mail:ctdongzhou@hotmail.com
Abstract    Objective    To explore the application value of three dimensional（3D） visualization in the hepatectomy of complex primary liver cancer（PLC）. Methods    The clinical data of 23 patients with complex PLC treated form March 2019 to March 2020 at the Fujian Provincial Cancer Hospital were retrospectively analyzed. Three-dimensional visualization technology was used in all patients to reconstruct liver three-dimensional graphics.Virtual liver resection was performed.The virtual resected liver volume was compared with the actual resected liver volume in patients undergoing surgery. Also postoperative complications were observed. Results    Twenty of the 23 patients underwent liver resection. No important blood vessels were injured during the operation.There were no serious postoperative complications such as bleeding and hepatic failure. All the patients of liver resection recovered and were discharged from hospital. There were no significant differences between the virtual resected liver volume and the actual resected liver volume（t=0.447，P>0.05）. There was an excellent positive correlation between the virtual resected liver volume and the actual resected liver volume（r=0.982，P<0.01）. Conclusion    Three-dimensional visualization can clearly show the hepatic vascular system and its adjacent relationship with tumor, calculate the future liver remnant after resection, simulate the optimal surgical paths, assist surgeon in preoperative communication. Three-dimensional visualization technology in hepatectomy of complex hepatocellular carcinoma will benefit to reduce risk of operation, develop a personalized surgical plan and reduce the incidence of postoperative complications.

Key words: complex hepatocellular carcinoma, three-dimensional visualization technology, precise hepatectomy