3D打印导板辅助骨盆肿瘤切除重建  

3D printed guider assisted pelvic tumor resection and reconstruction

作　　者：辛晓林[1] 王顺利[1] 彭庆州[1] XIN Xiao-lin;WANG Shun-li;PENG Qing-zho(First Department of Bone Tumor and Bone Disease,Zhengzhou Orthopaedic Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市骨科医院骨肿瘤骨病一科,河南郑州450000

出　　处：《中国矫形外科杂志》2023年第5期455-458,共4页Orthopedic Journal of China

基　　金：河南省科技攻关计划项目(编号:172102310480)。

摘　　要：[目的]介绍3D打印髋臼导板辅助骨盆肿瘤切除后重建的手术技术和初步临床效果。[方法]2017年1月—2018年10月本院18例骨盆肿瘤患者采用3D打印髋臼导板辅助骨盆肿瘤切除后重建。按术前影像明确骨盆内异常信号范围,判断肿瘤大小、侵犯程度及范围,以3D打印技术打印1∶1实物模型,进行手术模拟,确定切除与重建方案,并设计相应的导板。实际手术中,按术前方案,并在导板引导下施行肿瘤切除与骨盆重建。[结果]18例患者均顺利完成手术,且均获得随访,随访时间18~24个月。随访期间18例患者均存活,无因病死亡病例。肌肉骨骼肿瘤学会(musculoskeletal tumor society,MSTS)评分[5]由术前(12.6±2.0)分,显著增加至出院时(18.6±1.2)分,末次随访时(21.3±1.1)分,差异有统计学意义(P<0.05)。与术前比较,术后旋转中心距正中线距离、臼前倾角和外展角的患侧与健侧差值均减小,差异有统计学意义(P<0.05)。随访期间均未出现内固定松动或断裂,局部无复发。[结论]骨盆肿瘤切除及重建中应用3D打印髋臼导板具有手术时间短、术后恢复快、预后好等特点。[Objective]To introduce the surgical technique and preliminary clinical results of 3D printed guider assisted pelvic tumor resection and reconstruction.[Methods]From January 2017 to October 2018,18 patients underwent 3D printed guider assisted pelvic tumor resection and reconstruction in our hospital.Before operation,the margin of abnormal signals on the preoperative images were identified,and the tumor size and extent of tumor invasion were determined.After 1:1 real pelvis model was made by 3D printing,a surgical simulation was conducted to create the resection and reconstruction plan,and design the corresponding guider.In the actual operation,tumor resection and pelvic reconstruction were performed according to the preoperative plan and guided by the 3D printed guider.[Results]All 18 patients had operation completed successfully,and were followed up for 18~24 months.During the follow-up period,all 18 patients were alive without deaths due to the tumors.The Musculoskeletal Tumor Society(MSTS)score significantly increased from(12.6±2.0)preoperatively,to(18.6±1.2)at discharge,and(21.3±1.1)at the latest follow-up,which was statistically significant(P<0.05).Compared with those preoperatively,the bilateral differences between the affected side and healthy side in term of the distance of rotation center to midline,acetabular anteversion and acetabular abduction angle reduced significantly(P<0.05).During the follow-up period,no internal fixation loosening or breaking,and local recurrence were found in anyone of them.[Conclusion]The application of 3D printed acetabular guider in pelvic tumor resection and reconstruction has benefits of shortening operation time,improving postoperative recovery,and prognosis.

关 键 词：骨盆肿瘤 切除 重建 3D打印导板 

分 类 号：R738.1[医药卫生—肿瘤]