三维重建在微创食管癌根治术中的应用研究  

Application of 3D reconstruction in minimally invasive radical resection of esophageal cancer

作　　者：安小康[1] 董静 刘亚龙 丁钎州 张国瑜[1] 郑先杰[1] 张双林[1] An Xiaokang;Dong Jing;Liu Yalong;Ding Qianzhou;Zhang Guoyu;Zheng Xianjie;Zhang Shuanglin(Department of Thoracic Surgery,the First Affiliated Hospital of Henan University,Kaifeng 475000,China;Department of Blood Specialty,Kaifeng Children’s Hospital,Kaifeng 475000,China)

机构地区：[1]河南大学第一附属医院胸外科,开封475000 [2]开封市儿童医院血液科,开封475000

出　　处：《中华实验外科杂志》2024年第2期360-363,共4页Chinese Journal of Experimental Surgery

基　　金：河南省联合共建项目(LHGJ20210553);河南省医学教育研究项目(Wjlx2021056);河南省医学教育研究项目(Wjlx2021386);开封市科技计划项目(2203022);河南大学教学改革与实践项目(HDXJJG2022-050)。

摘　　要：目的分析三维重建在微创食管癌根治术中的应用价值。方法择取河南大学第一附属医院在2020年1月至2021年12月期间收治的46例食管癌患者, 借助随机数字表法分为对照组(n=23, 利用CT进行术前规划和术中应用)、观察组(n=23, 依据CT数据利用mimics软件于术前进行数字化三维重建并利用其进行术前规划和术中应用), 所有患者均实施微创食管癌根治术, 对比两组患者病变长度、食管淋巴结阳性检出率及准确率、手术时间、出血量、术后24 h引流量、并发症发生率、以及平均住院时间, 组间比较采用t检验。结果两组手术相关指标:手术时间观察组[(254.88±53.41) min]低于对照组[(341.26±67.85) min, t=4.798, P<0.05]、出血量观察组[(145.66±51.32) ml]低于对照组[(207.81±71.44) ml, t=3.388, P<0.05]、术后24 h引流量观察组[(187.11±44.95) ml]低于对照组[(241.62±50.41) ml, t=3.871, P<0.05]以及住院时间观察组[(13.02±1.44) d]低于对照组[(18.24±1.87) d, t=10.607, P<0.05], 差异有统计学意义;组间阳性检出率观察组95.65%(22/23)高于对照组[86.96%(20/23), χ^(2)=0.274, P>0.05], 差异无统计学意义;术前与术后病变长度比较, 观察组术前为(71.44±2.31) cm, 术后为(71.84±2.24) cm(t=0.195, P>0.05), 差异无统计学意义, 对照组观察组术前为(67.48±4.81) cm, 术后为(71.71±2.28) cm(t=3.559, P<0.05), 差异有统计学意义;观察组并发症发生率为8.70%(2/23)低于对照组[34.78%(8/23), χ^(2)=4.600, P<0.05], 差异有统计学意义。结论将三维重建用于微创食管癌根治术, 对患者病灶的检查准确度更高, 能够缩短患者手术时间、减少术中出血量、术后引流量, 降低并发症发生风险, 改善患者远期生活质量。Objective To analyze the application value of 3D reconstruction in minimally invasive radical resection of esophageal cancer.Methods A total of 46 patients with esophageal cancer admitted to the First Affiliated Hospital of Henan University from January 2020 to December 2021 were selected and divided into control group(n=23,preoperative planning and intraoperative application using CT)and observation group(n=23,mimics software used for preoperative digital 3D reconstruction based on CT data and used for preoperative planning and intraoperative application).All patients underwent minimally invasive radical resection of esophageal cancer.The length of lesion,positive detection rate and accuracy rate of esophageal lymph node,patient compliance,operation time,blood loss,24 h postoperative drainage volume,complication rate,and average length of hospital stay were compared between the two groups.Results Two groups of surgery-related indicators:Operation time of observation group[(254.88±53.41)min]was lower than that of control group[(341.26±67.85)min,t=4.798,P<0.05],blood loss of observation group[(145.66±51.32)ml]was lower than that of control group[(207.81±71.44)ml,t=3.388,P<0.05],24 h postoperative drainage volume in the observation group[(187.11±44.95)ml]was lower than that in the control group[(241.62±50.41)ml,t=3.871,P<0.05],and hospital stay in the observation group[(13.02±1.44)d]was lower than that in the control group[(18.24±1.87)d,t=10.607,P<0.05],the difference was statistically significant.The positive detection rate of observation group was 95.65%(22/23)higher than that of control group[86.96%(20/23),χ^(2)=0.274,P>0.05],and the difference was not statistically significant.Preoperative and postoperative lesion length was(71.44±2.31)cm in the observation group before surgery and(71.84±2.24)cm after surgery(t=0.195,P>0.05),and(67.48±4.81)cm after surgery,(71.71±2.28)cm in the control group(t=3.559,P<0.05),the difference was statistically significant.The complication rate of the observation group

关 键 词：食管癌 微创外科 并发症 

分 类 号：R735.1[医药卫生—肿瘤]