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Objective:To compare the application of preoperative planning of pediatric hepatoblastoma between three-dimensional and two-dimensional imaging of computer-assisted surgery system.Methods:From Jan 2016 to Oct 2019, surgical resection plans on 25 cases were made by the operator team through the observation of two-dimensional CT images. Then, the team will make a thorough analysis and revise the previous preoperative plan for the children patient according to three-dimensional imaging of the computer-assisted surgery system.Results:All the patients had the tumor successfully removed and achieved R 0 resection based on the preoperative plan assisted by three-dimensional imaging. All the children patients were doing well as found by postoperative short-term follow-up. Among them, preoperative plans were finally revised in 10 cases due to the disparity with the original ones in three-dimensional relationship between tumor and blood vessels, in vascular variation and in the volume of remnant liver after the evaluation of three-dimensional reconstruction images, which account for 40% variation of the original operation scheme. Conclusions:Three dimensional imaging of computer-assisted surgery system is superior to two-dimensional imaging in preoperative planning of pediatric hepatoblastoma.
RESUMO
Objective To explore the value of Hisense computer-assisted surgical systems (CAS) for precise surgery of pediatric solid pseudopapillary tumor.Methods A total of 5 cases with pancreatic solid pseudopapillary tumor who were admitted at the Affiliated Hospital of Qingdao University from June 2015 to September 2018 were adopting.Upper abdominal 64-slice dynamic enhanced computed tomography (CT) scan was performed.3D models were created by computer-assisted surgery systems.Based on 3D model,surgical planning,preoperative simulated tumor resection,intraoperative assisted guidance were performed.Operation time,intraoperative blood loss volume,blood transfusion rate were analyzed.Results Hisense CAS three-dimensional reconstruction could clearly show the adjacent relationship between pancreas,tumor and peripheral vascular organs.According to the preoperative virtual resection,pancreatic tumor resection was more accurate.Postoperative pathological results were solid pseudopapillary tumor of the pancreas.Among them,2 tumors were located in the head of the pancreas,1 case was located in the pancreatic neck,and 2 cases in the tail of the pancreas.The operation time was 150-360 min,with an average of 279 min.The average intraoperative blood loss was 40 mL,of which the minimum amount of bleeding was 5 mL,and the blood transfusion rate was 40％ (2/5 cases).Surgical tumor removal was achieved successfully in 5 cases.All children were followed up for 6 months to 3 years,and no recurrence or metastasis was observed.Conclusions Three-dimensional reconstruction of computer-assisted surgery system can clearly show the adjacent relationship between tumor and surrounding vascular organs,and help to make the best surgical plan before surgery to improve the accuracy and safety of the operation.
