男性盆腔结构数字化三维模型的构建及应用于腹腔镜膀胱癌根治术的初步研究  

Preliminary study on male pelvic digital 3D reconstruction model and its application in laparoscopic radical cystectomy

作　　者：钟伟柏 刘奇[1] 贾晨尧 陈柯[1] 许凯[1] 李虎林[1] ZHONG Weibo;LIU Qi;JIA Chenyao;CHEN Ke;XU Kai;LI Hulin(Department of U rology,Zhujiang Hospital of Southern Medical University,Guangzhou,510282,China)

机构地区：[1]南方医科大学珠江医院泌尿外科

出　　处：《临床泌尿外科杂志》2019年第11期857-861,共5页Journal of Clinical Urology

摘　　要：目的:构建男性盆腔结构的数字化三维模型,探讨其在腹腔镜膀胱癌根治术的应用价值。方法:选取2014年10月1日~2017年6月30日就诊于南方医科大学珠江医院泌尿外科的15例男性膀胱肿瘤患者,其中7例患者根据CT数据,术前应用数字化三维重建软件构建该患者的膀胱、输尿管、前列腺、精囊腺、骨盆及血管等盆腔结构,用于组建整体模型,指导术者行腹腔镜膀胱癌根治术(A组);8例患者使用CT图像进行术前规划(B组)。对患者基本信息、手术时间、术后血红蛋白下降、并发症发生率等进行统计学分析。结果:15例患者均成功施行腹腔镜手术;A组7例患者成功构建盆腔结构三维模型,直观地展示膀胱肿瘤及周围结构、盆腔血管的位置关系。A组和B组患者平均手术时间分别为(201.50±14.86)min和(219.75±12.32)min,差异有统计学意义(P<0.05);术后血红蛋白下降分别为(21.14±11.22)g/L和(27.75±7.80)g/L,并发症发生率分别为28.6%和50.0%,清扫淋巴结个数分别为(13.14±5.98)枚和(11.50±2.78)枚,两组比较差异均无统计学意义(P>0.05);两组术中均没有发生血管、神经损伤。结论:构建在体男性盆腔结构的数字化三维模型可让术者制定个体化术前规划,安全有效地应用于腹腔镜膀胱癌根治术,缩短手术时间。Objective:To construct in vivo male pelvic digitalized three dimensional model of bladder for use in laparoscopic radical cystectomy and make a preliminary study on its significance in clinical application.Method:From October 2014 to June 2017,15 patients confirmed bladder cancer at Zhujiang Hospital were collected.According to the CT data,the 3 D reconstruction model of bladder and adjacent organs(prostate,vessel,ureter and so on)was performed by the mimics 17.0 software before surgery and used for surgical planning in 7 patients(Group A).The preoperative planning was performed by CT data among another 8 patients(Group B).Patients’demographics,operation time,estimated blood loss,complication rate were analyzed.Result:All patients were accepted the surgery successfully.Seven cases were reconstructed and exhibited the relationship of bladder and closed organs vividly(Group A).In Group A and Group B,the operation time was[(201.50±14.86)min vs.(219.75±12.32)min,P<0.05],estimated blood loss was[(21.14±11.22)g/L vs.(27.75±7.80)g/L,P>0.05],complication rate was(28.6%vs.50.0%,P>0.05),the number of lymph nodes resected was[(13.14±5.98)vs.(11.50±2.78),P>0.05].Conclusion:In vivo male pelvic digitalized three dimensional model of bladder can help surgeons to understand the anatomical characteristic of patient for surgical planning.It is safe and effective,and it can shorten the operation time.

关 键 词：男性盆腔 数字化三维模型 膀胱癌根治术 

分 类 号：R737.14[医药卫生—肿瘤]