基于CT的可视化三维成像在后腹腔镜肾根治性切除术中的应用  

Application value of three dimensional CT reconstruction in laparoscopic radical nephrectomy

作　　者：邢力永 刘志飞[1] 蔡启亮[2] 朱研峰 邓刚[1] Xing Liyong;Liu Zhifei;Cai Qiliang;Zhu Yanfeng;Deng Gang(Department of Urology,Tangshan People′s Hospital,Tangshan 063000,China;Department of Urology,Second Hospital of Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]唐山市人民医院泌尿外科,唐山063000 [2]天津医科大学第二医院泌尿外科(天津市泌尿外科研究所),天津300211

出　　处：《国际泌尿系统杂志》2024年第1期114-117,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨基于CT的可视化三维成像在后腹腔镜肾根治性切除术中的应用价值。方法回顾性分析2019年1月至2020年3月唐山市人民医院收治的40例行后腹腔镜肾根治性切除术患者的临床资料,根据是否行基于CT的可视化三维模型重建的术前评估将患者分为研究组和对照组,每组各20例。研究组通过三维模型行术前评估,对照组通过强化CT、CT肾动脉血管造影(CTA)行术前评估,比较两组患者的术中出血量、手术时间、转开放手术例数、术后并发症、住院时间、术后肿瘤复发等临床资料。结果两组患者的年龄、性别、肿瘤大小、肿瘤分期、患侧比例、肾动静脉变异、术后并发症情况比较,差异均无统计学意义(均P>0.05)。研究组的手术时间、术中出血量、住院时间、术中转开放手术率均显著低于对照组(均P<0.05)。两组患者术后均未发生肿瘤复发与转移。结论腹腔镜肾根治性切除术患者术前进行基于CT的可视化三维重建,可明显减少术中副损伤发生,避免中转开放,缩短手术和住院时间,减少出血量。Objective To evaluate the application value of three dimensional computed tomography(CT)reconstruction in laparoscopic radical nephrectomy for renal tumor.Methods From January 2019 to March 2020,a retrospective cohort study was conducted on the clinical data of 40 patients with renal tumor treated by laparoscopic radical nephreclomy.Of which 20 patients were preoperatively based on the enhanced CT imaging data of both kidneys and used three dimensional visualization software perform fusion imaging reconstruction as the observation group.The other 20 patients was evaluated by intensive CT,CT renal artery angiography(CTA)before surgery as a control group.By comparing the clinical data of the two groups of patients,including the amount of bleeding,operation time,number of open cases,complications,hospital stay,and tumor recurrence,the significance of three-dimensional reconstruction imaging in laparoscopic nephrectomy was analyzed.Results There were no statistically significant comparisons between the two groups of patients in age,gender,tumor size,tumor stage,ratio of affected side,renal arteriovenous variation,and postoperative complications(all P>0.05).The operation time,operative blood loss,transfer to open surgery rate and hospital stay of the study group were significantly lower than those of the control group(all P<0.05).No tumor recurrence or metastasis occurred in the patients.Conclusions Preoperative visualization of CT-based three-dimensional reconstruction for patients with laparoscopic nephrectomy can significantly reduce the occurrence of intraoperative side injuries,avoid transfer to open,shorten the operation and hospitalization time,and reduce the amount of bleeding.

关 键 词：肾肿瘤 肾切除术 腹腔镜检查 体层摄影术 X线计算机 

分 类 号：R699.2[医药卫生—泌尿科学]