Traditional surgical planning of liver surgery is modified by 3D interactive quantitative surgical planning approach: a single-center experience with 305 patients
| Autor: | Xue-Dong Wang, Wei-dong Duan, Ying Luo, Jun Shi, Jiahong Dong, Ning Zhang, Hongguang Wang, Wenbin Ji |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Patient-Specific Modeling Target lesion China medicine.medical_specialty medicine.medical_treatment Clinical Decision-Making 030230 surgery Surgical planning 03 medical and health sciences Imaging Three-Dimensional 0302 clinical medicine Predictive Value of Tests Laparotomy Multidetector Computed Tomography medicine Hepatectomy Humans Prospective Studies Prospective cohort study Laparoscopy Retrospective Studies Hepatology medicine.diagnostic_test business.industry Patient Selection Gastroenterology Reproducibility of Results Retrospective cohort study Middle Aged Magnetic Resonance Imaging Surgery Treatment Outcome Liver Surgery Computer-Assisted 030220 oncology & carcinogenesis Predictive value of tests Radiographic Image Interpretation Computer-Assisted Female business |
| Zdroj: | Hepatobiliary & Pancreatic Diseases International. 16:271-278 |
| ISSN: | 1499-3872 |
| DOI: | 10.1016/s1499-3872(17)60021-3 |
| Popis: | Background Decision making and surgical planning are to achieve the precise balance of maximal removal of target lesion, maximal sparing of functional liver remnant volume, and minimal surgical invasiveness and therefore, crucial in liver surgery. The aim of this prospective study was to validate the accuracy and predictability of 3D interactive quantitative surgical planning approach (IQSP), and to evaluate the impact of IQSP on traditional surgical plans based on 2D images. Methods A total of 305 consecutive patients undergoing hepatectomy were included in this study. Surgical plans were created by traditional 2D approach using picture archiving and communication system (PACS) and 3D approach using IQSP respectively by two groups of physicians who did not know the surgical plans of the other group. The two surgical plans were submitted to the chief surgeon for selection before operation. The specimens were weighed. The two surgical plans were compared and analyzed retrospectively based on the operation results. Results The two surgical plans were successfully developed in all 305 patients and all the 3D IQSP surgical plans were selected as the final decision. Total 278 patients successfully underwent surgery, including 147 uncomplex hepatectomy and 131 complex hepatectomy. Twenty-seven patients were withdrawn from hepatectomy. In the uncomplex group, the two surgical plans were the same in all 147 patients and no statistically significant difference was found among 2D calculated resection volume (2D-RV), 3D IQSP calculated resection volume (IQSP-RV) and the specimen volume. In the complex group, the two surgical plans were different in 49 patients (49/131, 37.4%). According to the significance of differences, the 49 different patients were classified into three grades. No statistically significant difference was found between IQSP-RV and specimen volume. The coincidence rate of territory analysis of IQSP with operation was 92.1% (93/101) for 101 patients of anatomic hepatectomy. Conclusions The accuracy and predictability of 3D IQSP were validated. Compared with traditional surgical planning, 3D IQSP can provide more quantitative information of anatomic structure. With the assistance of 3D IQSP, traditional surgical plans were modified to be more radical and safe. |
| Databáze: | OpenAIRE |
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