临床小儿外科杂志2018，Vol.17Issue(3)：202-207,6.DOI:10.3969/j.issn.1671-6353.2018.03.009
计算机辅助手术系统在儿童腹膜后畸胎瘤手术中的应用研究
The applied study of computer assisted surgical system in the treatment of retroperitoneal teratoma in children
摘要
Abstract
Objective To explore the value of computer assisted surgical system(CAS)in precision surgery of retroperitoneal teratoma.Methods The clinical data of 16 hospitalized children with retroperitoneal teratoma from August 2013 to August 2017 were analyzed retrospectively.Abdominal dynamic enhanced compu-ted tomography(CT)scan was performed preoperatively(n=16).Hisense CAS system was used for three-di-mensional(3D)reconstruction as reconstruction group(n=9).Based on the CAS reconstruction results,accu-rate preoperative diagnosis and adjuvant surgical planning were performed for determining optimal surgical pro -tocols.The remaining 7 patients of control group underwent 3D CT reconstruction by CT Workstation.The clini-cal outcomes were analyzed and compared between two groups.3D reconstruction of abdominal organs and blood vessels was generated using Hisense CAS system.Diagnosis and preoperative planning assisted by the system were used for preoperative and intraoperative decision-making for precise surgery.Results The results of three-dimensional reconstruction could distinctly depict abdominal blood vessels,parenchymal organs and tumor tissue.Tumor tissue's structure might be observed stereoscopically from any angle and a separate display of or -gans around tumor was visible for operators to understand the spatial relationship between tumor and surround -ing tissue.Based upon the results of 3D reconstruction,preoperative evaluation and surgical planning were per-formed to reduce operative duration,blood loss and blood transfusion rate.The mean operative duration was shorter in reconstruction group than that in control group[(111 ±34.41)vs(145 ±29.92)min,P<0.05]. The mean intraoperative blood loss was lesser in reconstruction group than that in control group[(7 ±6.96)vs (30 ±34.48)ml,P<0.05].The rate of blood transfusion was lower in reconstruction group than that in con-trol group(22.22%vs 42.9%).The average hospitalization stay was shorter in reconstruction group than that in control group[(7 ±1.27)vs(8 ±2.1)days,P<0.05)].The difference was statistically significant. Conclusion Three-dimensional visualization technology can transform 2D into 3D images and enable full-di-mension rotation and zooming.Also it can depict tumor type and size,blood vessel distribution and anatomical correlation with other vessel and invasiveness in organs.It improves the safety and precision in young children undergoing retroperitoneal teratoma surgery.关键词
成像,三维/腹膜后畸胎瘤/精准外科/儿童Key words
Imaging/Three-Dimensional/Retroperitoneal Teratoma/Precise surgery/Child引用本文复制引用
朱荣坤,邢茂青,郭静,张虹,邴春梅,张亚楠,段于河,董蒨,杨传民,郝希伟..计算机辅助手术系统在儿童腹膜后畸胎瘤手术中的应用研究[J].临床小儿外科杂志,2018,17(3):202-207,6.基金项目
十二五国家科技支撑计划课题(2013BAI01B03) （2013BAI01B03）
