Davi Shunji Yahiro, Mariana de Paula Cruz, Brenda Ficheira Coelho Ribeiro, Luiza Meireles Teixeira, Maria Fernanda Ribeiro Mendes de Oliveira, Aurea Lúcia Alves de Azevedo Grippa de Souza, Ana Flávia Malheiros Torbey, Juliana Serafim da Silveira, Claudio Tinoco Mesquita
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引用次数: 0
摘要
背景:由于心脏解剖结构复杂,先天性心脏病(CHD)给手术治疗带来了巨大挑战。在先天性心脏病手术的术前规划、术中指导和医学教育方面,三维(3D)打印技术已成为一种前景广阔的工具:我们旨在系统地回顾有关三维打印技术在心脏外科手术干预中的应用和益处的文献:我们在 PubMed 和 EMBASE 上对截至 2024 年 2 月发表的研究进行了系统检索。我们纳入了调查 3D 打印技术在心脏病患者手术中作用的对照和非对照研究。我们进行了单臂荟萃分析,估算了因使用 3D 打印模型而改变治疗计划的比例。此外,将 3D 打印与传统治疗方法进行比较的研究也纳入了荟萃分析。P值小于0.05被认为具有统计学意义:共有21项研究符合纳入标准,包括444名在3D打印辅助下接受心脏疾病手术的患者。75例患者中有35例(51.8%;95% CI 26.6-77.0%,I2=80.68%,p=0.001)在三维模型辅助下进行术前规划,改变了手术决策,三维打印组的总手术时间缩短了22.25分钟(95%CI 49.95;5.80分钟,I2=0%,p=0.817),但无统计学意义。尽管样本较少,但其他终点(机械通气和重症监护室时间)也显示了该技术的一些益处,但无统计学意义:通过提供个性化的解剖模型,3D 打印技术可促进手术规划和实施。结论:通过提供个性化的解剖模型,3D 打印技术可为手术规划和执行提供便利,但还需要更多的研究来探讨 3D 打印技术对减少干预、住院和机械通气时间的影响。
Impact of 3D Printing on Cardiac Surgery in Congenital Heart Diseases: A Systematic Review and Meta-Analysis.
Background: Congenital heart disease (CHD) poses significant challenges in surgical management due to the complexity of cardiac anatomy. Three-dimensional (3D) printing has emerged as a promising tool in preoperative planning, intraoperative guidance, and medical education for CHD surgeries.
Objectives: We aimed to systematically review the literature on the utilization and benefits of 3D printing technology in CHD surgical interventions.
Methods: A systematic search was conducted across PubMed and EMBASE for studies published up to February of 2024. We included controlled and uncontrolled studies investigating the surgical role of 3D printing in CHD patients. We conducted a single-arm meta-analysis estimating the proportion of change in treatment planning due to the use of 3D printed-models. Moreover, studies that compared 3D printing to conventional care were included into the meta-analysis. A p-value < 0.05 was considered statistically significant.
Results: A total of 21 studies met the inclusion criteria, comprising 444 patients undergoing CHD surgeries with 3D printing assistance. Preoperative planning aided by 3D models led to changing surgical decisions in 35 of 75 cases (51.8%; 95% CI 26.6-77.0%, I2=80.68%, p=0.001) and reduced total operative time in 22.25 minutes in favor of the 3D printing group (95%CI 49.95; 5.80 min, I2=0%, p=0.817) but without statistical significance. Albeit in a smaller sample, other endpoints (mechanical ventilation and ICU time) demonstrated some benefit from the technology but without statistical significance.
Conclusions: By providing personalized anatomical models, 3D printing may facilitate surgical planning and execution. More studies are needed to investigate the effects of 3D printing on reducing intervention, hospitalization, and mechanical ventilation times.