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Objective:To analyze and summarize the application and significance of the computer-assisted surgery system in precision surgery of mediastinal tumors in children.Methods:The clinical data of 54 children that underwent mediastinal tumor resection surgery in the Affiliated Hospital of Qingdao University from August 2008 to November 2021 were collected.According to whether the Hisense CAS computer-assisted surgery system was used before the operation, the patients were divided into three-dimensional (3D) reconstruction group (29 cases, 53.70%) and two-dimensional (2D) CT group (25 cases, 46.30%). The surgical indicators, postoperative hospital stay, and the incidence of surgical complications were compared between the two groups.The t-test, Mann- Whitney U test, χ2 test or Fisher′ s exact test were carried out for statistical analysis.Simulated surgery and actual surgery were compared for both 3D reconstruction and 2D CT groups. Results:There were no significant differences in gender, age, height, weight, maximum tumor diameter and tumor location between the 3D reconstruction group and 2D CT group (all P>0.05). The operation time of the 3D reconstruction group was [(125.14±41.37) min] was shorter than that of the 2D CT group [(149.24±44.53) min] ( P=0.044). The intraoperative blood loss in the 3D reconstruction group [15.00(13.50, 25.00) mL] was less than that in the 2D CT group [36.00(30.00, 75.00) mL] ( P<0.001). In addition, the indwelling time the closed thoracic drainage tube [4.00 (3.00, 5.50) d] and postoperative hospitalization days [(8.83±3.39) d] in the 3D reconstruction group were shorter than those in the 2D CT group [7.00(5.00, 11.50) d, (11.00±4.10) d] ( P=0.001, 0.038). No significant difference in postoperative complication rates was found between the 3D reconstruction group and 2D CT group ( P>0.05). The simulated operation was consistent with the actual operation in the 3D reconstruction group. Conclusions:3D reconstruction by the computer-assisted surgery system can truly reveal the anatomical relationship between tumors and surrounding organs and blood vessels, and improve the accuracy and safety of surgical resection of mediastinal tumors in children.
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Objective:To compare the application of preoperative planning of pediatric hepatoblastoma between three-dimensional and two-dimensional imaging of computer-assisted surgery system.Methods:From Jan 2016 to Oct 2019, surgical resection plans on 25 cases were made by the operator team through the observation of two-dimensional CT images. Then, the team will make a thorough analysis and revise the previous preoperative plan for the children patient according to three-dimensional imaging of the computer-assisted surgery system.Results:All the patients had the tumor successfully removed and achieved R 0 resection based on the preoperative plan assisted by three-dimensional imaging. All the children patients were doing well as found by postoperative short-term follow-up. Among them, preoperative plans were finally revised in 10 cases due to the disparity with the original ones in three-dimensional relationship between tumor and blood vessels, in vascular variation and in the volume of remnant liver after the evaluation of three-dimensional reconstruction images, which account for 40% variation of the original operation scheme. Conclusions:Three dimensional imaging of computer-assisted surgery system is superior to two-dimensional imaging in preoperative planning of pediatric hepatoblastoma.