Liao Wenge,Zhu Junjie,Zhang Haodong,et al.Application of three-dimensional visualization technology for pediatric solid tumors[J].Journal of Clinical Pediatric Surgery,,22():655-659.[doi:10.3760/cma.j.cn101785-202112034-010]
Application of three-dimensional visualization technology for pediatric solid tumors
- Keywords:
- Response Evaluation Criteria in Solid Tumors; Imaging; Three-Dimensional; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the application value of preoperative three-dimensional visualization technology for pediatric solid tumors.Methods Retrospective analysis was performed for 23 children with solid tumors from January 2019 to December 2021.According to whether or not three-dimensional visualization was applied preoperatively, they were divided into two groups of study (n=11) and control (n=12).The research team performed three-dimensional visualization of computed tomography (CT) images, explored the spatial and three-dimensional relationship between tumors and adjacent organs and blood vessels and clarified whether or not adjacent blood vessels had mutations.Pecise preoperative planning was implemented under the guidance of three-dimensional model.The control group was operated merely under the guidance of traditional CT images.General profiles and intraoperative data of two groups were compared.Results All operations were successfully completed.The age of study and control groups was[(3.1±0.9) vs.(2.1±0.6) year], body weight[(12.2±2.7) vs.(15.7±2.5) kg]and length of hospitalization[(11.4±1.8) vs.(13.4±1.6) day].Regarding intraoperative data, operative duration of study and control groups was[(330.4±61.0) vs.(208.8±30.7) min], intraoperative blood loss[(43.6±17.6) vs.(204.2±70.2) mL] and frequency of intraoperative blood transfusion (transfusion/non-transfusion)[(1/10) vs.(6/6)], maximal tumor diameter[(8.0±0.8) vs.(10.5±1.2) cm]and volume error values[(4.3±0.9) vs.(15.4±1.6) cm3].Regarding perioperative complications, anemia (n=1 vs.3), hypoproteinemia (n=1 vs.1) and abnormal coagulation function (n=1 vs.1) occurred in study group.In control group, anemia (n=3), incision infection (n=0), hypoproteinemia (n=1) and abnormal coagulation function (n=1).Intraoperative blood loss, blood transfusion and volume error of study group were all smaller than those of control group.The inter-group difference was statistically significant (P<0.05).Conclusion Preoperative three-dimensional visualization technology is both effective and convenient for assessing the resection of solid tumors.It is of a great value for improving the accuracy and safety of solid tumors in children.
References:
[1] Allen-Rhoades W, Whittle SB, Rainusso N.Pediatric solid tumors of infancy:an overview[J].Pediatr Rev, 2018, 39(2):57-67.DOI:10.1542/pir.2017-0057.
[2] El-Gendi A, Fadel S, El-Shafei M, et al.Avoiding liver transplantation in post-treatment extent of disease III and IV hepatoblastoma[J].Pediatr Int, 2018, 60(9):862-868.DOI:10.1111/ped.13634.
[3] Sato Y, Matsuhashi N, Sugie Y, et al.Total laparoscopic resection by medial-retroperitoneal approach using virtual navigation:two case reports of primary retroperitoneal schwannoma[J].World J Surg Oncol, 2022, 20(1):3.DOI:10.1186/s12957-021-02483-0.
[4] 韩善清, 房加高, 陈爱萍, 等.基于三维可视化技术的后腹膜肿瘤精准手术切除[J].中国数字医学, 2020, 15(1):58-60.DOI 10.3969/j.issn.1673-7571.2020.01.019. Han SQ, Fang JG, Chen AP, et al.Precise surgical resection of retroperitoneal tumor based upon three dimensional visualization technology[J].China Digit Med, 2020, 15(1):58-60.DOI:10.3969/j.issn.1673-7571.2020.01.019.
[5] 李曜, 王志恒, 李鹏鹏, 等.三维可视化技术与公式法测定肝脏肿瘤体积的对比研究[J].腹部外科, 2019, 32(1):17-22.DOI:10.3969/j.issn.1003-5591.2019.01.004. Li Y, Wang ZH, Li PP, et al.Comparative study of three dimensional visualization technology versus traditional formula for measuring liver tumor volume[J].J Abdom Surg, 2019, 32(1):17-22.DOI:10.3969/j.issn.1003-5591.2019.01.004.
[6] Li HJ, Fan WG, Zhu X.Three-dimensional printing:the potential technology widely used in medical fields[J].J Biomed Mater Res A, 2020, 108(11):2217-2229.DOI:10.1002/jbm.a.36979.
[7] Schmelz K, Toedling J, Huska M, et al.Spatial and temporal intratumour heterogeneity has potential Consequences for single biopsy-based neuroblastoma treatment decisions[J].Nat Commun, 2021, 12(1):6804.DOI:10.1038/s41467-021-26870-z.
[8] Anand S, Krishnan N, Goel P, et al.Utility of three-dimensional printing for preoperative assessment of children with extra-cranial solid tumors:a systematic review[J].Pediatr Rep, 2022, 14(1):32-39.DOI:10.3390/pediatric14010006.
[9] Sánchez-Sánchez á, Girón-Vallejo ó, Ruiz-Pruneda R, et al.Three-dimensional printed model and virtual reconstruction:an extra tool for pediatric solid tumors surgery[J].European J Pediatr Surg Rep, 2018, 6(1):e70-e76.DOI:10.1055/s-0038-1672165.
[10] 范煦, 鹿洪亭, 周显军, 等.Hisense计算机辅助系统辅助腹腔镜精准手术治疗儿童肾上腺区巨大肿瘤[J].临床小儿外科杂志, 2020, 19(1):50-53, 58.DOI:10.3969/j.issn.1671-6353.2020.01.010. Fan X, Lu HT, Zhou XJ, et al.Hisense computer-aided system assisted laparoscopy for an accurate treatment of large adrenal tumors in children[J].J Clin Ped Sur, 2020, 19(1):50-53, 58.DOI:10.3969/j.issn.1671-6353.2020.01.010.
[11] Lewis RM, Pearson-Farr JE.Multiscale three-dimensional imaging of the placenta[J].Placenta, 2020, 102:55-60.DOI:10.1016/j.placenta.2020.01.016.
[12] Lupulescu C, Sun ZH.A systematic review of the clinical value and applications of three-dimensional printing in renal surgery[J].J Clin Med, 2019, 8(7):990.DOI:10.3390/jcm8070990.
[13] Li XH, Wen L, Liu J, et al.Three-dimensional printing-driving liver therapies[J].Curr Med Chem, 2021, 28(33):6931-6953.DOI:10.2174/0929867328666210419124246.
[14] 赵頔, 叶进冬, 李华丽, 等.肝脏三维可视化重建技术在儿童复杂肝母细胞瘤肝切除术中的应用价值[J].临床肝胆病杂志, 2021, 37(9):2130-2135.DOI:10.3969/j.issn.1001-5256.2021.09.025. Zhao D, Ye JD, Li HL, et al.Application of liver three-dimensional visualized reconstruction technique during hepatectomy for children with complicated hepatoblastoma[J].J Clin Hepatol, 2021, 37(9):2130-2135.DOI:10.3969/j.issn.1001-5256.2021.09.025.
[15] Huber T, Huettl F, Tripke V, et al.Experiences with three-dimensional printing in complex liver surgery[J].Ann Surg, 2021, 273(1):e26-e27.DOI:10.1097/SLA.0000000000004348.
[16] 胡正飞, 吕世栋, 黄建锋, 等.3D空间测量与传统CT规划在肾肿瘤微创手术中的对比[J].南方医科大学学报, 2018, 38(5):606-611.DOI:10.3969/j.issn.1673-4254.2018.05.017. Hu ZF, Lyu SD, Huang JF, et al.Three-dimensional spatial measurement versus conventional CT planning during laparoscopic nephrectomy for renal tumors[J].J South Med Univ, 2018, 38(5):606-611.DOI:10.3969/j.issn.1673-4254.2018.05.017.
[17] Wellens LM, Meulstee J, van de Ven CP, et al.Comparison of 3-dimensional and augmented reality kidney models with conventional imaging data in the preoperative assessment of children with Wilms tumors[J].JAMA Netw Open, 2019, 2(4):e192633.DOI:10.1001/jamanetworkopen.2019.2633.
Memo
收稿日期:2021-12-20。
基金项目:2021年成都市医学科研课题（2021030）
通讯作者:彭强,Email:pengqiangpq@sina.com