Yang Chao,Wang Shan,Li Changchun,et al.Application of three-dimensional printing technology in vascular skeletal surgery for children with retroperitoneal neuroblastoma[J].Journal of Clinical Pediatric Surgery,,18():376-380.[doi:10.3969/j.issn.1671-6353.2019.05.008]
Application of three-dimensional printing technology in vascular skeletal surgery for children with retroperitoneal neuroblastoma
- Keywords:
- Betroperitoneal Neoplasms/SU; Neuroblastoma/SU; 3D printing; Child
- CLC:
- R729;R739.4;R857.3
- Abstract:
- Objective To explore the value of three-dimensional (3D) printing in vascular skeletal surgery for children with retroperitoneal neuroblastoma.Methods From January 2016 to June 2018,hospitalized children with retroperitoneal neuroblastoma fulfilling the inclusion criteria were divided into 3D and non-3D print groups according to whether 3D tumor model was printed preoperatively.Tumor size,operative duration,surgical resection rate and complication rate were recorded.Family members responded to a questionnaire and the results were statistically analyzed.Results For 15 children in 3D printing group,there were 7 boys and 8 girls with an average age of (40.5±28.6) months;for 25 children in non-3D printing group,there were 13 boys and 12 girls with an average age of (43.3±24.8) months.3D model could delineate a distinct relationship between tumor,adjacent organs and blood vessels.All of them successfully underwent vascular skeletal tumor resection.No significant inter-group differences existed in gender,age,tumor stage size,number of tumor invaded vessel,surgical resection rate,complication rate,postoperative recurrence or survival rate (P>0.05).In non-3D printing group (P<0.05),family members’ scores on the degree of disease mastery were significantly higher than those in non-3D printing group (P<0.05).Conclusion 3D printing tumor model can distinctly delineate the complex anatomical relationship of retroperitoneal neuroblastoma in children.And it is conducive for preoperative planning,shortening operative duration and improving the awareness of family members on surgical approaches and patient-physician rapports.
References:
1 Van Golen CM,Soules ME,Grauman AR,et al.N-Myc overexpression leads to decreased beta1 integrin expression and increased apoptosis in human neuroblastoma cells[J].Oncogene,2003,22(17):2664-2673.DOI:10.1038/sj.onc.1206362.
2 Newman EA,Abdessalam S,Aldrink JH,et al.Update on neuroblastoma[J].J Pediatr Surg,2018,S0022-3468(18):30574-30578.DOI:10.1016/j.jpedsurg.2018.09.004.
3 张文举,滕勇,季明华,等.基于3D打印技术辅助治疗胫骨远端粉碎性骨折[J].中国医学装备,2017,14(12):60-64.DOI:10.3969/J.ISSN.1672-8270.2017.12.017.Zhang WJ,Teng Y,Ji MH,et al.Adjuvant treatment for comminuted fractures of distal tibia based on 3D printing technique[J].China Medical Equipment,2017,14(12):60-64.DOI:10.3969/J.ISSN.1672-8270.2017.12.017.
4 方驰华,方兆山,范应方,等.三维可视化、3D打印及3D腹腔镜在肝肿瘤外科诊治中的应用[J].南方医科大学学报,2015,35(5):639-645.DOI:10.3969/j.issn.1673-4254.2015.05.04.Fang CH,Fang ZS,Fan YF,et al.Application of 3D visualization,3D printing and 3D laparoscopy in the diagnosis and surgical treatment of hepatic tumors[J].Journal of Southern Medical University,2015,35(5):639-645.DOI:10.3969/j.issn.1673-4254.2015.05.04.
5 Wang J,Yang M,Zhu Y,et al.Phage nanofibers induce vascularized osteogenesis in 3D printed bone scaffolds[J].Adv Mater,2014,26(29):4961-4966.DOI:10.1002/adma.201400154.
6 Schmauss D,Juchem G,Weber S,et al.Three-dimensional printing for perioperative planning of complex aortic arch surgery[J].Ann Thorac Surg,2014,97(6):2160-2163.DOI:10.1016/j.athoracsur.2014.02.011.
7 Chan HH,Siewerdsen JH,Vescan A,et al.3D rapid prototyping for otolaryngology-head and neck surgery:applications in image-guidance,surgical simulation and patient-specific modeling[J].PLoS One,2015,10(9):e0136370.DOI:10.1371/journal.pone.0136370.
8 中国抗癌协会小儿肿瘤专业委员会,中华医学会小儿外科学分会肿瘤外科学组.儿童神经母细胞瘤诊疗专家共识[J].中华小儿外科杂志,2015,36(1):3-7.DOI:10.3760/cma.j.issn.0253-3006.2015.01.002.CCCG,Oncology Surgery Group,Society of Pediatric Surgery,Chinese Medical Association.Expert consensus of diagnosing and treating pediatric neuroblastoma[J].Chin J Pediatr Surg,2015,36(1):3-7.DOI:10.3760/cma.j.issn.0253-3006.2015.01.002.
9 Mirilas P,Skandalakis JE.Surgical anatomy of the retroperitoneal spaces,Part V:Surgical applications and complications[J].Am Surg,2010,76(4):358-364.
10 Fang CH,Tao HS,Yang J,et al.Impact of three-dimensional reconstruction technique in the operation planning of centrally located hepatocellular carcinoma[J].J Am Coll Surg,2015,220(1):28-37.DOI:10.1016/j.jamcollsurg.2014.09.023.
11 Lee N.The Lancet Technology:3D printing for instruments,models,and organs?[J].Lancet,2016,388(10052):1368.DOI:10.1016/S0140-6736(16)31735-4.
12 葛宏伟,张弋,李宁忱,等.3D打印技术在肾肿瘤手术规划中的应用研究初探[J].中华泌尿外科杂志,2014,35(9):659-663.DOI:10.3760/cma.j.issn.1000-6702.2014.09.007.Ge HW,Zhang Y,Li NC,et al.Application of 3D-printing technology in surgical planning for renal tumor:a preliminary report[J].Chin J Urol,2014,35(9):659-663.DOI:10.3760/cma.j.issn.1000-6702.2014.09.007.
13 姬文晨,蒋婉婷,李志强,等.3D打印结合PBL在骨科住院医师规范化培训中的应用[J].中国医学教育技术,2017,31(1):64-67.DOI:10.13566/j.cnki.cmet.cn61-1317/g4.201701019.Ji WC,Jiang WT,Li ZQ,et al.Combined use of 3D printing and PBL in orthopedic residents’ standardized training[J].China Medical Education Technology,2017,31(1):64-67.DOI:10.13566/j.cnki.cmet.cn61-1317/g4.201701019.
14 段光琦,王啸,刘洁,等.3D打印技术在儿童腹膜后肿瘤手术规划中的应用[J].临床小儿外科杂志,2017,16(5):430-435.DOI:10.3969/j.issn.1671-6353.2017.05.004.Duan GQ,Wang X,Liu J,et al.Application of 3-dimensional printing in surgical planning for pediatric retroperitoneal tumor[J].J Clin Ped Sur,2017,16(5):430-435.DOI:10.3969/j.issn.1671-6353.2017.05.004.
15 Yang T,Lin S,Tan T,et al.Impact of 3D printing technology on comprehension of surgical anatomy of retroperitoneal tumor[J].World J Surg,2018,42(8):2339-2343.DOI:10.1007/s00268-018-4489-x.
Memo
收稿日期:2018-10-20。
基金项目:重庆市卫生计生委医学科研计划项目(编号:2016MSXM042),重庆市研究生教育教学改革研究项目(编号:yjg20163022)
通讯作者:杨超,Email:400843@hospital.cqmu.edu.cn