混合现实技术在腹膜后神经鞘瘤手术中的应用价值  

Application value of mixed reality technology in surgical treatment of retroperitoneal schwannoma

作　　者：李诗哲 刘金鑫 张赫 陈挺[1] 李佳桐 商冠宁 LI Shizhe;LIU Jinxin;ZHANG He;CHEN Ting;LI Jiatong;SHANG Guanning(Department of Orthopedics,Shengjing Hospital Affiliated to China Medical University,Liaoning Shenyang 110022,China;Graduate School,Jinzhou Medical University,Liaoning Jinzhou 121001,China)

机构地区：[1]中国医科大学附属盛京医院骨科,辽宁沈阳110022 [2]锦州医科大学研究生院,辽宁锦州121001

出　　处：《现代肿瘤医学》2023年第6期1039-1043,共5页Journal of Modern Oncology

基　　金：中国医科大学附属盛京医院345人才工程项目(编号:M0744,M0944);中国博士后科学基金(编号:2021M693912)。

摘　　要：目的:探讨混合现实技术在腹膜后神经鞘瘤手术治疗中的临床疗效与应用价值。方法:回顾性分析2021年1月至2022年4月于我院收治的19例腹膜后神经鞘瘤患者的临床资料,其中男5例,女14例,年龄(42.4±13.2)(20~72)岁,肿瘤最大径为(6.65±2.82)(3.1~11.7)cm。所有患者术前均行肿瘤部位增强三维重建CT扫描,通过混合现实技术对肿瘤的大小、周围解剖关系进行分析,并统计手术失血量及手术时长。同时对手术后的病例进行随访观察。结果:19例患者均行腹膜外入路手术,其中5例患者行经腹直肌外缘切口入路手术,8例行经髂腹股沟切口入路手术,5例行经骶尾部弧形切口入路手术,1例行经腹骶前后联合入路手术。所有患者按照术前方案完整切除肿瘤,肿瘤周围血管神经均保护完好,手术时间(86.3±39.8)(30~182)min,术中失血量(266.8±413.9)(30~1 500)mL。术后3例出现并发症,包括下肢疼痛和排尿异常。全部病例获得随访,随访时间(8.0±3.7)(3~14)个月,随访期内病例未见复发。结论:手术切除是腹膜后神经鞘瘤的首选治疗方式,术前应选择合适手术入路。混合现实技术可用于腹膜后神经鞘瘤的诊疗过程,有助于手术的精准操作。Objective:To investigate the clinical efficacy and application value of mixed reality technology in the surgical treatment of retroperitoneal schwannoma.Methods:The 19 patients with retroperitoneal schwannoma who were admitted to our hospital from January 2021 to April 2022 were retrospectively analyzed, including 5 males and 14 females.Age was(42.4±13.2)(20~72)years old.The largest tumor diameter was(6.65±2.82)(3.1~11.7)cm.All patients receieved enhanced three-dimensional reconstruction CT scan before operation.The size of the tumor and the surrounding anatomical relationship were analyzed by mixed reality technology, and the intraoperative blood loss and operation time were recorded.Meanwhile, all patients were followed up regularly.Results:All 19 patients underwent extraperitoneal approach.Among them, 5 patients underwent rectus abdominis lateral incision approach, 8 patients underwent ilioinguinal approach, 5 patients underwent transsacral approach, and 1 patient underwent combined abdominal and sacral approach.All patients obtained complete tumor resection according to the preoperative protocol, and the blood vessels and nerves around the tumor were well preserved.The operation time was(86.3±39.8)(30~182)min, and the intraoperative blood loss was(266.8±413.9)(30~1 500)mL.Postoperative complications occurred in 3 patients, including lower extremity pain and abnormal urination.All cases were followed up for(8.0±3.7)(3~14)months.No tumor recurrence was found during the follow-up period.Conclusion:Surgical resection is the first choice for the treatment of retroperitoneal schwannoma, and an appropriate surgical approach should be taken in consideration before operation.Mixed reality technology can be used in the diagnosis and treatment of retroperitoneal schwannoma, which is helpful for precise operation.

关 键 词：腹膜后神经鞘瘤 混合现实 术前评估 手术入路 精准化手术 

分 类 号：R730.264[医药卫生—肿瘤]