VR辅助下累及大血管的腹膜后肿瘤3例MDT讨论  

Discussion on three cases of retroperitoneal tumor involving great vessels by MDT mode under the aid of VR

作　　者：刘涛 陈琨 李文岗[1] LIU Tao;CHEN Kun;LI Wengang(Department of Hepatobiliary Surgery,School of Medicine of Xiamen University/Xiang'an Hospital of Xiam en University,Xiamen,Fujian 361102,P.R.China)

机构地区：[1]厦门大学医学院/厦门大学附属翔安医院肝胆外科,福建厦门361102

出　　处：《中国普外基础与临床杂志》2021年第5期649-656,共8页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨多学科协作团队(MDT)模式在累及大血管的腹膜后肿瘤中的应用价值。方法回顾性分析厦门大学附属翔安医院于2019年收治的3例累及大血管的腹膜后肿瘤患者的临床资料。该3例患者在三维可视化重建和虚拟现实(VR)技术支持下,经MDT讨论后接受了手术、介入、靶向治疗等个体化治疗。结果病例1经MDT讨论后认为,根据CT检查、三维重建和VR虚拟图像结果,右侧肿瘤判断为完整切除,而左侧肿瘤判断为无法切除,拟定治疗方案为右侧转移瘤切除+左侧转移瘤射频消融;术后病例1已随访6个月,腹泻症状明显改善,复查CT提示肝脏病灶及左侧腹膜后病灶大小同前,病情稳定。病例2经MDT讨论后,于肿瘤周围行射频消融后,再分块切除;术后病例2已随访3个月,复查CT检查示腹膜后未见新发病灶。病例3经MDT讨论后认为存在动静脉瘘、无手术指征,行介入联合靶向治疗;治疗后8个月复查见肿瘤较治疗前缩小,疗效评价为部分缓解,继续随访中。结论利用三维可视化重建和VR技术,并在MDT模式下评估患者的病情,制定手术联合其他治疗的个体化治疗方案,是累及大血管的腹膜后肿瘤治疗的未来发展趋势。Objective To explore the application value of multidisciplinary collaborative team(MDT)model in retroperitoneal tumors involving large vessels.Methods Three cases of retroperitoneal tumors involving great vessels admitted to Xiang’an Hospital of Xiamen University in 2019 were retrospectively analyzed.With the support of 3 D visual reconstruction and virtual reality(VR)technology,we performed MDT discussion and three cases received treatment of surgery,intervention,and targeted therapy.Results Case 1 was discussed by MDT and concluded that,based on CT examination,3 D reconstruction,and VR virtual image results,the tumor on the right side was determined to be completely resectable.The left tumor was judged to be unresectable,and the proposed treatment plan was right metastatic tumor resection+left metastatic tumor radiofrequency ablation.After surgery case 1 had been followed up for6 months.The symptoms of diarrhea were significantly improved.CT reexamination showed that liver lesions and left retroperitoneal lesions were the same size and the condition was stable.After discussion by MDT,radiofrequency ablation around the tumor was proposed for case 2.This case was followed up for 3 months after surgery,and CT reexamination showed no new lesion in retroperitoneum.After MDT discussion,we concluded that arteriovenous fistula of case 3 had no indications for surgery,and proposed interventional combined with targeted therapy.After treatment,the tumor was found to be smaller after reexamination in 8 months than before treatment,and the efficacy was evaluated as partial remission.The follow-up was continued.Conclusion The future development trend of retroperitoneal tumor therapy involving great vessels is to evaluate each patient’s condition under the MDT mode by using 3 D visual reconstruction and VR technology,and to formulate the individualized treatment plan of operation combined with other treatments.

关 键 词：腹膜后肿瘤 多学科协作团队 虚拟现实 三维可视化 个体化治疗 

分 类 号：R735.4[医药卫生—肿瘤]