Application of independently-designed three-demensional printed navigation templates for hepatectomy in hepatic surgical oncology / 中华肝胆外科杂志

ABSTRACT

Objective To investigate the clinical value of independently-designed three-demensional printed navigation templates for hepatectomy in hepatic surgical oncology.Methods A retrospective study was conducted on 45 patients (including 36 males and 9 females,aged from 40 to 70 years) with hepatocelluar carcinoma treated by hepatoctomy from Department of Hepatobiliary and Intestinal Surgery of Hunan Cancer Hospital from June 2016 to June 2018.These patients were divided into observation group (patients conducted with the 3D navigation-template-aided operation,n =25) and control group (patients conducted with regular operation,n =20) according to operation approach.Virtual liver resection volume and actual liver resection volume were calculated in the observation group,and the correlationship between the volume of virtual liver resection and actual liver resection was analyzed by Pearson correlation analysis.The operative time,intraoperative blood loss,intraoperative intrahepatic duct injury and postoperative hospital stay were compared between the two groups.Results In the observation group,3D modeling was successfully completed and intrahepatic and extrahepatic duct reconstruction was successful,surgical simulation.There were no statistically significant difference between the virtual and actual resected liver volume in the observation group (P ＞ 0.05).The virtual resected liver volume was positively correlated with the actual resected liver volume (r =0.991,P ＜ 0.05).Volume of intraoperative blood loss in the observation group was lower than that in the control group [(245.1 ±22.3) ml vs.(308.6 ± 19.9) ml],and the length of hospital stay was shorter than that in the control group [(7.4 ±0.2) d vs.(8.6 ±0.4) d],the difference was statistically significant (P ＜ 0.05).There was no accidental injury of intrahepatic duct in the observation group,1 case of accidental injury of middle hepatic vein and 1 case of accidental injury of secondary branch of right hepatic vein in the control group.The AST of the observation group was significantly reduced compared with that of the control group on the 4 th and 7th days after the operation,and the difference was statistically significant (P ＜ 0.05).Conclusions 3D reconstruction of liver based on high quality MR images,can facilitate restoring the adjoint relationship between hepatic duct system and liver tumor.3D printed navigation templates effectively guide certain kinds of hepatectomy,ensure that the cutting edge at the same time protect the rest of the liver tissue,reduce bleeding and accidental damage,realize accurate tumor resection.