三维可视化技术在腹壁肿瘤外科中的应用

目的探讨三维可视化技术在腹壁肿瘤术前评估中的应用价值。 方法回顾性分析2017年11月至2019年4月，上海交通大学医学院附属第九人民医院收治的23例腹壁肿瘤患者的临床资料。患者术前行腹部增强CT检查获取影像学信息，以医学数字成像和通信格式储存，并应用Medraw软件进行三维重建及数据分析，精准计算腹壁肿瘤体积和腹壁缺损面积，精准评估腹壁缺损分型及分区并制定个性化手术方案。 结果23例患者均进行三维重建并进行精准分型及分区及制定个性化手术方案，其中原发性腹壁肿瘤患者15例，继发性腹壁肿瘤患者7例。腹壁肿瘤平均体积为（355.18±820.13）cm³，腹壁缺损平均面积为（216.2±145.49）cm²；术中平均出血量（334.78±271.54）ml，平均住院时间（21.22±8.65）d；平均随访时间为（12.1±6.87）个月。患者的存活率为86.96%（20/23），原发性腹壁肿瘤复发率为13.33%（2/15），继发性腹壁肿瘤复发率28.57%（2/7）；术后并发症的发生率为34.78%（8/23）。 结论三维可视化技术能够对腹壁肿瘤患者进行精准评估及制定个性化手术方案。

Application of three-dimensional visualization technology in abdominal wall tumor surgery

ObjectiveTo explore the value of medical three-dimensional visualization technology in preoperative precise assessment for abdominal wall tumor. MethodsThe clinical data of 23 patients were analyzed retrospectively from November 2017 to April 2019 in Shanghai Ninth People's Hospital. CT scanning was performed and the data was stored in the form of DICOM. Three-dimensional reconstruction and related data analysis were performed by the Medraw software, which can accurately show the calculation of abdominal wall tumor volume, abdominal wall defect area, abdominal wall defect classification and zoning, and develop a personalized surgical plan. ResultsTwenty three patients underwent three- dimensional reconstruction of abdominal wall tumors and designed a personalized surgical plan. Among them, there were 15 cases of primary abdominal wall tumor and 7 cases of secondary abdominal wall tumor. Preoperative three-dimensional reconstruction could accurately obtain the average volume of abdominal wall tumors (355.18±820.13) cm³, abdominal wall defect area (216.2±145.49) cm². The mean blood loss was (334.78±271.54) ml, and the average hospital stay was (21.22±8.65) days. The mean follow-up time was (12.1±6.87) months, the patient survival rate was 86.96% (20/23), the primary abdominal wall tumor recurrence rate was 13.33% (2/15), and the secondary abdominal wall tumor recurrence rate was 28.57% (2/7); the incidence of postoperative complications was 34.78% (8/23). ConclusionThree-dimensional visualization technology can be used for the accurate evaluation of patients with abdominal wall tumors before surgery and designed a personalized surgical plan.