Li Meijiao,Xiu Wenli,Wu Xiongwei,et al.Application and significance of computer-assisted surgical system in children’s ganglioneuroblastoma surgery[J].Journal of Clinical Pediatric Surgery,2025,(04):345-350.[doi:10.3760/cma.j.cn101785-202407037-008]
计算机辅助手术系统在儿童节细胞神经母细胞瘤手术中的应用
- Title:
- Application and significance of computer-assisted surgical system in children’s ganglioneuroblastoma surgery
- Keywords:
- Neuroblastoma; Ganglioneuroblastoma; Surgical Procedures; Operative; Computer-assisted surgery; Treatment Outcome; Child
- 摘要:
- 目的 探讨计算机辅助手术系统在儿童节细胞神经母细胞瘤手术中的应用价值。方法 回顾性分析2013年1月至2023年12月在青岛大学附属医院小儿外科接受手术治疗的33例节细胞神经母细胞瘤患儿临床资料,根据术前是否应用Hisense CAS进行三维重建,将患儿分为二维CT组(n=17)和三维重建组(n=16),采用Mann-Whitney U检验、χ2检验或Fisher精确概率法比较两组患儿在手术时间、术中失血量、术后住院时间及复发情况等方面的差异。结果 三维重建组手术时长(131.40±41.60)min,短于二维CT组的(169.39±57.82)min;术中失血量20(10.0,27.5)mL,少于二维CT组的30(20.0,60.0)mL;术后引流管留置时间也短于二维CT组,差异均有统计学意义(P＜0.05)。两组均随访至2024年4月,二维CT组中3例复发、1例死亡。三维重建组患儿术中情况与术前三维重建结果高度一致,均完整切除肿瘤,无一例残留,随访期间均存活,无一例复发与转移。结论 采取计算机辅助手术系统进行三维重建,通过对节细胞神经母细胞瘤进行术前影像评估,可以辅助设计和优化手术方案,使手术更加精准、安全,对儿童节细胞神经母细胞瘤的手术治疗具有重要的指导意义。
- Abstract:
- Objective To explore the clinical application value and significance of computer-assisted surgical system for gangliocytic neuroblastoma (GNB) in children.Methods From January 2013 to December 2023,the clinical data of 33 surgical GNB children were retrospectively reviewed.According to whether or not using Hisense CAS for 3D preoperative reconstruction,they were assigned into two groups of two-dimensional CT reconstruction (n=17) and three-dimensional CT reconstruction (n=16).Mann-Whitney U,χ2 and Fisher exact tests were utilized for examining the inter-group differences in operative duration,intraoperative volume of blood loss,postoperative hospitalization stay and recurrence.Results Operative duration was shorter in three-dimensional CT reconstruction group than that in two-dimensional CT group .Median intraoperative volume of blood loss was less in three-dimensional CT reconstruction group than that in two-dimensional CT reconstruction group .Postoperative indwelling time of drainage tube was shorter than that of two-dimensional CT reconstruction group (P<0.05).Follow-ups were conducted until April 2024.In two-dimensional CT reconstruction group,there were postoperative recurrence (n=3) and death (n=1).It was probably correlated with an incomplete resection of multiple tumor metastases.Intraoperative status of three-dimensional CT reconstruction group was highly consistent with that of preoperative three-dimensional CT reconstruction.Tumors were completely removed without any residue.There was no recurrence or metastasis.Conclusions Through preoperative imaging of ganglioneuroblastoma,3D reconstruction of computer-assisted surgery system assists in designing and optimizing surgical protocols so as to enable operations to be more accurate and safe.It has important guiding significance for managing pediatric GNB.
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备注/Memo
收稿日期:2024-7-8。
基金项目:国家自然科学基金(82293665)
通讯作者:董蒨,Email:18661801885@163.com