计算机辅助手术系统在小儿纵隔肿瘤精准手术中的应用  

Application of a computer-assisted surgery system in precision surgery of mediastinal tumors in children

作　　者：刘瑶[1] 吴雄伟 段于河[1] 赵春阳 王菲菲[1] 王凤娇 夏楠[1] 郝希伟[1] 董蒨[1,2] Liu Yao;Wu Xiongwei;Duan Yuhe;Zhao Chunyang;Wang Feifei;Wang Fengjiao;Xia Nan;Hao Xiwei;Dong Qian(Department of Pediatric Surgery,the Affiliated Hospital of Qingdao University,Qingdao 266000,China;Qingdao University Institute of Digital Medicine and Computer Assisted Surgery,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院小儿外科,青岛266000 [2]青岛大学数字医学与计算机辅助手术研究院,青岛266000

出　　处：《中华实用儿科临床杂志》2022年第22期1750-1755,共6页Chinese Journal of Applied Clinical Pediatrics

基　　金："十二五"国家科技支撑计划课题(2013BAI01B03);山东省重点研发计划(2015GSF118130)。

摘　　要：目的分析总结计算机辅助手术系统在小儿纵隔肿瘤精准手术中的应用和意义。方法回顾性分析2008年8月至2021年11月在青岛大学附属医院行手术治疗的54例纵隔肿瘤患儿的临床资料,根据术前是否应用Hisense CAS计算机手术辅助系统分为三维重建组(29例,53.70%)和二维CT组(25例,46.30%)。对比2组手术指标、术后住院时间、手术并发症发生率等方面的差异,应用t检验、Mann-Whitney U检验、χ^(2)检验或Fisher′s精确概率法进行统计学分析;对比2种方法模拟手术与实际手术情况。结果三维重建组与二维CT组患儿性别、年龄、身高、体重、肿瘤最大径、肿瘤位置的差异均无统计学意义(均P>0.05);三维重建组的手术时长[(125.14±41.37)min]短于二维CT组[(149.24±44.53)min](P=0.044);三维重建组的术中出血量[15.00(13.50,25.00)mL]少于二维CT组[36.00(30.00,75.00)mL](P<0.001);并且三维重建组的胸腔闭式引流管引流时间[4.00(3.00,5.50)d]和术后住院天数[(8.83±3.39)d]均短于二维CT组[7.00(5.00,11.50)d、(11.00±4.10)d](P=0.001、0.038);三维重建组和二维CT组术后并发症发生率比较差异无统计学意义(P>0.05)。三维重建组模拟手术与手术实际探查情况相符。结论使用计算机手术辅助系统进行三维重建能真实显示肿瘤与周围器官、血管的解剖关系,可提高儿童纵隔肿瘤手术切除的准确性和安全性。Objective To analyze and summarize the application and significance of the computer-assisted surgery system in precision surgery of mediastinal tumors in children.Methods The clinical data of 54 children that underwent mediastinal tumor resection surgery in the Affiliated Hospital of Qingdao University from August 2008 to November 2021 were collected.According to whether the Hisense CAS computer-assisted surgery system was used before the operation,the patients were divided into three-dimensional(3D)reconstruction group(29 cases,53.70%)and two-dimensional(2D)CT group(25 cases,46.30%).The surgical indicators,postoperative hospital stay,and the incidence of surgical complications were compared between the two groups.The t-test,Mann-Whitney U test,χ^(2) test or Fisher′s exact test were carried out for statistical analysis.Simulated surgery and actual surgery were compared for both 3D reconstruction and 2D CT groups.Results There were no significant differences in gender,age,height,weight,maximum tumor diameter and tumor location between the 3D reconstruction group and 2D CT group(all P>0.05).The operation time of the 3D reconstruction group was[(125.14±41.37)min]was shorter than that of the 2D CT group[(149.24±44.53)min](P=0.044).The intraoperative blood loss in the 3D reconstruction group[15.00(13.50,25.00)mL]was less than that in the 2D CT group[36.00(30.00,75.00)mL](P<0.001).In addition,the indwelling time the closed thoracic drainage tube[4.00(3.00,5.50)d]and postoperative hospitalization days[(8.83±3.39)d]in the 3D reconstruction group were shorter than those in the 2D CT group[7.00(5.00,11.50)d,(11.00±4.10)d](P=0.001,0.038).No significant difference in postoperative complication rates was found between the 3D reconstruction group and 2D CT group(P>0.05).The simulated operation was consistent with the actual operation in the 3D reconstruction group.Conclusions 3D reconstruction by the computer-assisted surgery system can truly reveal the anatomical relationship between tumors and surrounding organs and b

关 键 词：精准手术 计算机辅助手术 纵隔肿瘤 儿童 

分 类 号：TP391.7[自动化与计算机技术—计算机应用技术] R734.5[自动化与计算机技术—计算机科学与技术]