增强现实技术在胰十二指肠切除术中的应用价值

Q4 Medicine
Rui Tang, Xinjing Zhang, Guochen Ning, Ang Li, Lihan Yu, H. Liao, Jiahong Dong, Q. Lu
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引用次数: 1

摘要

目的探讨增强现实技术在胰十二指肠切除术中的应用价值。方法采用回顾性和描述性研究。收集2018年6月至2019年2月在清华大学附属北京清华长庚医院接受帕金森病治疗的3名男性患者的临床病理数据。这3名患者的年龄从52岁到63岁,中位年龄为57岁。收集增强型计算机断层扫描的数字成像和通信标准格式数据,重建腹动脉、门静脉、十二指肠降支、胰体和胰尾、胰头、胆总管和胰管的三维图像。结果被导入AR软件。术中导航采用基于二维码的光学跟踪和手动交互式刚性配准。观察指标:(1)手术及术后情况;(2) 术后病理检查;(3) 后续行动。截至2019年6月,通过门诊检查或电话访谈进行随访,以检测患者的生存率以及肿瘤转移和复发情况。具有偏斜分布的测量数据表示为M(范围)。计数数据用绝对数表示。结果(1)手术及术后情况:3例患者均成功应用AR技术作为术中导航进行PD。手术时间、术中失血量和术后住院时间分别为6小时(范围5-8小时)、700毫升(范围300-900毫升)、11天(范围9-12天)。无围手术期死亡或并发症发生。术后,PD联合肠系膜上静脉(SMV)切除重建的患者在增强型计算机断层扫描检查中有明显的SMV。(2) 术后病理检查:病理检查显示胰腺导管内乳头状黏液性肿瘤(IPMN)伴侵袭性腺癌(侵袭SMV的肿瘤)1例,胰岛素瘤1例,壶腹周围神经内分泌癌1例。(3) 随访:3例患者随访4-12个月,中位随访时间为6个月。在随访中,胰腺IPMN和侵袭性腺癌患者在术后3个月出现肝转移,并在其他医院接受化疗。经过4个周期的化疗,转移性结节缩小,患者仍在随访中,直到随访截止日期。2例无复发或转移。结论AR技术辅助PD是安全可行的,有助于识别血管分支和轨迹。关键词:胰腺肿瘤;增强现实技术;三维重建;胰十二指肠切除术;外科导航
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Application value of augmented reality technology in pancreatoduodenectomy
Objective To investigate the application value of augmented reality (AR) technology in pancreatoduodenectomy (PD). Methods The retrospective and descriptive study was conducted. The clinicopathological data of 3 male patients who underwent PD in Tsinghua University Affiliated Beijing Tsinghua Changgung Hospital from June 2018 to February 2019 were collected. The 3 patients were aged from 52 to 63 years, with a median age of 57 years. Digital imaging and communication standard format data of enhanced computed tomography (CT) scan were collected, the three-dimensional (3D) images of abdominal arteries, portal vein, descending duodenum, pancreatic body and tail, pancreatic head, common bile duct, and pancreatic duct were reconstructed. The results were imported into the AR software. Optical tracking based on two-dimensional codes and manual interactive rigid registration were adopted for intraoperative navigation. Observation indicators: (1) surgical and postoperative conditions; (2) postoperative pathological examination; (3) follow-up. Follow-up using outpatient examination or telephone interview was conducted to detect survival of patients and tumor metastasis and recurrence up to June 2019. The measurement data with skewed distribution were expressed as M (range). Count data were expressed as absolute numbers. Results (1) Surgical and postoperative conditions: all the 3 patients underwent PD with AR technology as intraoperative navigation successfully. The operation time, volume of intraoperative blood loss, and duration of postoperative hospital stay were 6 hours (range, 5-8 hours), 700 mL (range, 300-900 mL), 11 days (range, 9-12 days). There was no perioperative death or complication occured. After surgery, the patients who underwent PD combined with superior mesenteric vein (SMV) resection and reconstruction had patent SMV on the enhanced computed tomography examination. (2) Postoperative pathological examination: results of pathological examination showed 1 case of intraductal papillary mucinous neoplasm (IPMN) of the pancreas with invasive adenocarcinoma (neoplasm invading SMV), 1 case of insulinoma, and 1 case of periampullary neuroendocrine carcinoma, respectively. (3) Follow-up: 3 patients were followed up for 4-12 months, with a median follow-up time of 6 months. During the follow-up, the patient with IPMN of the pancreas and invasive adenocarcinoma had liver metastasis at 3 months after surgery, and received chemotherapy at other hospital. After 4 cycles of chemotherapy, the metastatic nodule shrank, and the patient was still in follow-up up to deadline of follow-up. Other 2 patients had no recurrence or metastasis. Conclusion AR technique assisted PD is safe and feasible, which is helpful to indentify vascular branches and tracks. Key words: Pancreatic neoplasms; Augmented reality technology; Three-dimensional reconstruction; Pancreatoduodenectomy; Surgical navigation
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中华消化外科杂志
中华消化外科杂志 Medicine-Gastroenterology
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