天津医药

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计算机辅助三维定量分析及模拟手术设计系统在精准肝切除中的应用

高伟1,朱志军1,魏林1,曾志贵2,杨涛3,吴迪4,李俊杰1,王建5   

  1. 1. 天津市第一中心医院
    2.
    3. 一中心
    4. 第一中心医院移植外科
    5. 天津市第一中心医院移植外科
  • 收稿日期:2011-07-28 修回日期:2011-08-02 出版日期:2012-02-15 发布日期:2012-02-15
  • 通讯作者: 朱志军

Application of computer-assisted 3-dimensional quantitative assessment and virtual surgical system in precise hepatectomy

  • Received:2011-07-28 Revised:2011-08-02 Published:2012-02-15 Online:2012-02-15

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摘要： 目的：探讨计算机辅助三维定量分析及模拟手术设计系统在精准肝切除中的作用。方法：我院2010年6月—2011年6月应用IQQA肝脏CT影像解读分析系统对17例拟行精确肝切除的患者进行肝脏三维重建，精确定位肝脏肿瘤并明确肿瘤与血管的解剖关系，计算全肝体积、拟切除肝脏体积、剩余肝脏体积、剩余肝脏体积及标准化全肝体积的比值（RSLVR）等数据，并据此设计手术方案。结果：17例患者的全肝体积平均为（1744.5±881.6）mL，拟切除肝体积平均为（919.2±884.4）mL，剩余肝体积平均为（825.3±228.6）mL，RSLVR平均为（67.6±22.3）%。所有患者均行解剖性肝切除，手术过程顺利，术后并发症包括胆漏1例，胸腔积液6例，中等量以上腹水4例，肺感染1例。结论：计算机辅助三维定量分析及模拟手术设计系统可精确定位肝脏肿瘤，并辅助设计最优化的手术方案。

关键词: 肝切除术, 计算机辅助设计, 成像, 三维, 肝肿瘤

Abstract: Objective: To assess the effect of computer-assisted 3-dimensional quantitative assessment and virtual surgical system for precise hepatectomy. Methods: The clinical data of 17 patients who had undergone precise hepatectomy at Tianjin First Center Hospital from June 2010 to June 2011 were retrospectively analyzed. EDDA’s IQQA?-Liver was used for constructed the 3-dimensional imaging of liver, and the anatomic relationship between hepatic vessel and tumor was analyzed. Total liver volume, predicted resection volume, the remnant liver volume and remnant-standard liver volume ratio (RSLVR) were calculated, and the operative program was planned according it. Results: Of the 17 patients, total liver volume was calculated as 1744.5±881.6ml, predicted resection volume as 919.2±884.4ml, the remnant liver volume as825.3±228.6ml, and RSLVR as 67.6%±22.3%. All patients received anatomical hepatectomy, and postoperative complications included bile leak in 1case, pleural effusion in 6 cases, moderate or massive ascites in 4 cases and pulmonary infection in l case. Conclusion: computer-assisted 3-dimensional quantitative assessment and virtual surgical system helped to determine the tumor localization and to plan optimal liver resection operations. It should be wide used for precise hepatectomy.

Key words: hepatectomy computer-aided designimaging, three-dimensionalliver neoplasms