精准外科时代3D可视化技术在肝癌切除术中的应用价值

目的探讨精准外科时代3D可视化技术在肝癌切除术中的应用价值。方法采用随机数字表法将100例原发性肝癌患者分为3D组和常规组,每组50例,3D组患者实施3D可视化技术辅助肝癌切除术,常规组患者实施常规肝癌切除术。比较两组患者的手术情况、肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平]、肝功能损伤程度、术后并发症发生情况、术后1年生存及复发情况。结果3D组患者的术中出血量明显少于常规组,肝门阻断时间和手术时间均明显短于常规组,差异均有统计学意义(P﹤0.01)。两组患者的实际切除肝体积比较,差异无统计学意义(P﹥0.05)。术后第1天、第3天、第5天,3D组患者的ALT和AST水平均低于常规组,差异均有统计学意义(P﹤0.05)。3D组患者的肝功能损伤程度明显小于常规组,差异有统计学意义(P﹤0.01)。3D组患者的术后并发症总发生率为18.0%(9/50),明显低于常规组的56.0%(28/50),差异有统计学意义(P﹤0.01)。3D组患者的1年生存率高于常规组,1年复发率低于常规组,差异均有统计学意义(P﹤0.05)。结论精准外科时代3D可视化技术应用于肝癌切除术中能够有效减轻患者肝组织的损伤程度,减少术后并发症,延长患者的生存时间,具有良好的应用价值。

The application value of 3D visualization technology in hepatectomy for liver cancer in the era of precision surgery

Objective To discuss the application value of 3D visualization technology in hepatectomy for liver cancer in the era of precision surgery.Method 100 patients with liver cancer were randomly divided into 3D group and conventional group,50 patients in each group.The patients of the 3D group underwent 3D visualization technology assisted hepatectomy for liver cancer,while the patients of the conventional group underwent conventional hepatectomy for liver cancer.The operation conditions,liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST)levels],degree of liver function damage,postoperative complications,1-year survival and recurrence were compared between the two groups.Result The bleeding volume in 3D group was significantly lower than that of the conventional group,and the time of hepatic portal block and operation were significantly shorter than that of the conventional group(P<0.01).There was no significant difference in the actual resected liver volume between the two groups(P>0.05).On the 1st,3rd and 5th day after operation,the levels of ALT and AST in the 3D group were lower than those in the conventional group(P<0.05).The degree of liver function damage in 3D group was significantly less than that in conventional group(P<0.01).The total incidence of postoperative complications in 3D group was 18.0%(9/50),which was significantly lower than 56.0%(28/50)in conventional group(P<0.01).The 1-year survival rate of 3D group was higher than that of conventional group,and the 1-year recurrence rate was lower than that of conventional group(P<0.05).Conclusion In the era of precision surgery,the application of 3D visualization technology in hepatectomy for liver cancer can effectively reduce the degree of damage to liver tissues and postoperative complications,prolong the survival time of patients,and have a good prognostic effect.