计算机辅助手术系统在小儿胰腺实性假乳头状瘤手术中的应用  

Application of computer-assisted system in surgery for pediatric solid pseudopapillary tumor

作　　者：王英明 周显军[1] 陈鑫[1] 张虹[1] 董蒨[1] 郝希伟[1] 李富江[1] 段于河[1] Wang YM;Zhou XJ;Chen X;Zhang H;Dong Q;Hao XW;Li FJ;Duan YH(Department of Pediatric Surgery,the Affiliated Hospital of Qingdao University,Qingdao 266003,Shandong Province,China)

机构地区：[1]青岛大学附属医院小儿外科,山东青岛266003

出　　处：《中华实用儿科临床杂志》2019年第21期1658-1661,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的研究海信计算机辅助手术系统(CAS)在小儿胰腺实性假乳头状瘤手术中的应用价值及临床意义。方法对青岛大学附属医院2015年6月至2018年9月收治的5例胰腺实性假乳头状瘤行上腹部64排螺旋CT增强扫描,应用CAS进行三维重建,基于数字化三维模型制定手术方案,术前模拟肿瘤切除,术中辅助指导;分析手术时间、术中出血量、输血率等。结果数字化三维重建结果可清晰显示胰腺肿瘤与周围血管、脏器的毗邻关系,基于个性化模型虚拟手术,实现精准切除。术后病理结果均为胰腺实性假乳头状瘤。5例肿瘤中2例位于胰头,1例位于胰颈,2例位于胰体尾。手术时间为150~360 min,平均279 min,术中出血量平均40 mL,最少出血量为5 mL,输血率40%(2/5例),5例患儿均成功切除肿瘤,康复出院;随访6个月~3年,均未见复发和转移。结论CAS三维重建能清晰显示肿瘤与周围血管、脏器的毗邻关系,术前制定最佳手术方案,提高手术的精准性与安全性。Objective To explore the value of Hisense computer-assisted surgical systems(CAS)for precise surgery of pediatric solid pseudopapillary tumor.Methods A total of 5 cases with pancreatic solid pseudopapi-llary tumor who were admitted at the Affiliated Hospital of Qingdao University from June 2015 to September 2018 were adopting.Upper abdominal 64-slice dynamic enhanced computed tomography(CT)scan was performed.3D models were created by computer-assisted surgery systems.Based on 3D model,surgical planning,preoperative simulated tumor resection,intraoperative assisted guidance were performed.Operation time,intraoperative blood loss volume,blood transfusion rate were analyzed.Results Hisense CAS three-dimensional reconstruction could clearly show the adjacent relationship between pancreas,tumor and peripheral vascular organs.According to the preoperative virtual resection,pancreatic tumor resection was more accurate.Postoperative pathological results were solid pseudopapillary tumor of the pancreas.Among them,2 tumors were located in the head of the pancreas,1 case was located in the pancreatic neck,and 2 cases in the tail of the pancreas.The operation time was 150-360 min,with an average of 279 min.The average intraoperative blood loss was 40 mL,of which the minimum amount of bleeding was 5 mL,and the blood transfusion rate was 40%(2/5 cases).Surgical tumor removal was achieved successfully in 5 cases.All children were followed up for 6 months to 3 years,and no recurrence or metastasis was observed.Conclusions Three-dimensional reconstruction of computer-assisted surgery system can clearly show the adjacent relationship between tumor and surroun-ding vascular organs,and help to make the best surgical plan before surgery to improve the accuracy and safety of the operation.

关 键 词：胰腺实性假乳头状瘤 外科手术 计算机辅助 成像 三维 

分 类 号：R73[医药卫生—肿瘤]