Peter Joseph Mounsef, Benjamin Blackman, Ojasvi Sharma, Ahmed Aoude, Anthony Bozzo
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引用次数: 0
Abstract
Introduction: Three-dimensional printing (3DP) technology has increasingly gained attention in orthopedic oncology, where complex tumor resections and reconstructions demand high precision. 3DP enables the creation of patient-specific models and prostheses, which can improve postoperative quality of life for patients while assisting surgeons in preoperative planning, enhancing surgical accuracy, and improving outcomes in complex oncologic cases. Despite its potential, comprehensive data on the effectiveness and applications of 3DP in orthopedic oncology are limited. This paper assesses whether using 3DP compared to conventional techniques results in better outcomes in orthopedic oncology.
Methods: A comprehensive search of Ovid MEDLINE, Embase, Scopus, and Web of Science was conducted until November 2024. Studies comparing 3D printing to conventional methods in orthopedic oncology and reporting outcomes such as operative time, blood loss, recurrence rates, or functional scores were included. Weighted means and meta-analyses were conducted to compare these outcomes. Statistical heterogeneity was adjusted by using a random-effects model.
Results: Fourteen studies comprising 478 patients met the inclusion criteria. Our primary findings were improved MSTS scores (mean difference [MD]: 2.17, p = 0.00) and decreased blood loss (MD: -69.8 mL, p = 0.00) in the 3D printing groups. There was no significant difference in operative time between 3D printing and conventional techniques (MD: -12.2 min, p = 0.32). Tumor recurrence rates did not differ significantly between groups (relative risk: 0.88, p = 0.50). Subgroup analyses indicated that 3D-printed implants showed the greatest benefit in reducing OR time and blood loss, with the other subgroups showing no significant difference in OR time, blood loss, or recurrence rate.
Conclusion: The findings suggest that 3D printing in orthopedic oncology may enhance surgical precision by reducing OR time, intraoperative blood loss, and improving postoperative function, without affecting recurrence rates. Substantial heterogeneity limits confidence in these findings.
导读：三维打印（3DP）技术在骨科肿瘤学领域越来越受到关注，因为复杂的肿瘤切除和重建需要高精度。3d打印可以创建患者特定的模型和假体，这可以提高患者的术后生活质量，同时帮助外科医生进行术前规划，提高手术准确性，并改善复杂肿瘤病例的预后。尽管具有潜力，但关于3d打印在骨科肿瘤学中的有效性和应用的综合数据有限。本文评估了与传统技术相比，在骨科肿瘤学中使用3d打印技术是否能获得更好的结果。方法：综合检索Ovid MEDLINE、Embase、Scopus和Web of Science，检索截止日期为2024年11月。将3D打印与传统方法在骨科肿瘤学中进行比较，并报告手术时间、出血量、复发率或功能评分等结果。采用加权平均数和荟萃分析来比较这些结果。采用随机效应模型调整统计异质性。结果：14项研究478例患者符合纳入标准。我们的主要发现是3D打印组的MSTS评分提高（平均差值[MD]: 2.17, p = 0.00），出血量减少（MD: -69.8 mL, p = 0.00）。3D打印与常规技术在手术时间上无显著差异（MD: -12.2 min, p = 0.32）。两组间肿瘤复发率无显著差异（相对危险度：0.88,p = 0.50）。亚组分析表明，3d打印植入物在减少手术时间和出血量方面表现出最大的益处，其他亚组在手术时间、出血量或复发率方面没有显着差异。结论：3D打印在骨科肿瘤手术中可通过减少手术时间、术中出血量、改善术后功能来提高手术精度，且不影响复发率。实质性的异质性限制了这些发现的可信度。证据等级：三级。
期刊介绍：
The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.
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