Application of three-dimensional visualization technology in the treatment of complex hepatic echinococcosis

doi:10.3877/cma.j.issn.1674-0793.2023.04.004

Abstract

Abstract:

Objective

To investigate the effect of three-dimensional visualization technology in the treatment of complex hepatic echinococcosis.

Methods

The data of 67 cases with complex hepatic echinococcosis undergoing standard radical resection in the People’s Hospital of Aba Tibetan and Qiang Autonomous Prefecture from January 2019 to July 2022 were collected. The patients were divided into two groups according to whether CT three-dimensional reconstruction was performed before surgery: 32 cases in the study group were accurately evaluated using CT reconstruction and 3D visualization technology of simulated liver resection; 35 cases in the control group received CT 2D enhanced scanning before operation. Baseline data, perioperative indicators, and incidence of postoperative complications were compared between the two groups. The satisfaction of intraoperative condition and preoperative CT film reading and doctor-patient communication were investigated with questionnaire survey in the two groups.

Results

The operation was successful in both groups, and there were no perioperative deaths. There was significant difference in the conversion of surgical methods between the study group and the control group (0 vs 14.29%, χ²=4.940, P=0.026). The operation time, intraoperative bleeding and postoperative hospital stay in the study group were significantly reduced compared with the control group (all P<0.05). There were complications of pulmonary infection and pleural effusion in both groups, and the incidence of postoperative bile leakage in the study group was lower than that in the control group (0 vs 14.29%, χ²=4.940, P=0.026). The score of satisfaction with intraoperative condition and preoperative CT film reading in the study group was (94.22±3.39), significantly higher than (88.14±3.66) in the control group, the score of doctor-patient communication satisfaction in the study group was (87.34±4.40), significantly higher than (80.71±5.02) in the control group, and the differences were statistically significant (t=-7.038, -5.726, both P<0.001).

Conclusion

Three-dimensional visualization technology in the treatment of complex hepatic echinococcosis is helpful for operation decision-making, significantly improves the satisfaction of doctor-patient communication, reduces the operation time, intraoperative bleeding and postoperative hospitalization stay, and is worthy of clinical promotion.

Key words: Hepatic hydatidosis, Hepatectomy, Three-dimensional visualization technology

Falan Tian, Jianzhong Chen, Zhuoma Zaxi, Dinggang Yu. Application of three-dimensional visualization technology in the treatment of complex hepatic echinococcosis[J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(04): 257-261.

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References 13

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项目	研究组	对照组	统计值	P值
例数	32	35
性别(例)			0.464	0.495
男	12(37.50)	16(45.71)
女	20(62.50)	19(54.29)
年龄(岁)^a	40.71±11.80	41.56±12.55	-0.285	0.776
合并高血压(例)	4(12.50)	6(17.14)	0.284	0.594
合并糖尿病(例)	2(6.25)	3(8.57)	0.130	0.718
血红蛋白(g/L)^a	142.13±11.75	144.71±10.94	0.934	0.354
谷氨酸转氨酶(U/L)^a	40.11±5.73	38.69±3.12	1.244	0.218
总胆红素(μmol/L)^a	17.37±2.84	17.47±4.18	-0.112	0.911
白蛋白(g/L)^a	38.06±2.30	37.59±2.43	0.801	0.426
病灶直径(cm)^a	9.80±0.73	9.92±0.76	0.624	0.535
病灶位置(例)
左半肝	15(46.88)	17(48.57)	0.019	0.890
右半肝	12(37.50)	14(40.00)	0.044	0.834
肝三叶	5(15.62)	4(11.43)	0.253	0.615
分型(例)			0.276	0.600
P3/4N0/1M0	28(87.50)	32(91.43)
P3/4N0/1M1	4(12.50)	3(8.57)

项目	研究组	对照组	统计值	P值
例数	32	35
性别(例)			0.464	0.495
男	12(37.50)	16(45.71)
女	20(62.50)	19(54.29)
年龄(岁)^a	40.71±11.80	41.56±12.55	-0.285	0.776
合并高血压(例)	4(12.50)	6(17.14)	0.284	0.594
合并糖尿病(例)	2(6.25)	3(8.57)	0.130	0.718
血红蛋白(g/L)^a	142.13±11.75	144.71±10.94	0.934	0.354
谷氨酸转氨酶(U/L)^a	40.11±5.73	38.69±3.12	1.244	0.218
总胆红素(μmol/L)^a	17.37±2.84	17.47±4.18	-0.112	0.911
白蛋白(g/L)^a	38.06±2.30	37.59±2.43	0.801	0.426
病灶直径(cm)^a	9.80±0.73	9.92±0.76	0.624	0.535
病灶位置(例)
左半肝	15(46.88)	17(48.57)	0.019	0.890
右半肝	12(37.50)	14(40.00)	0.044	0.834
肝三叶	5(15.62)	4(11.43)	0.253	0.615
分型(例)			0.276	0.600
P3/4N0/1M0	28(87.50)	32(91.43)
P3/4N0/1M1	4(12.50)	3(8.57)

观察指标	研究组	对照组	统计值	P值
例数	32	35
手术方式中转	0(0)	5(14.29)	4.940	0.026^b
胆肠吻合	0(0)	2(5.71)
胆管吻合+T管引流	0(0)	1(2.86)
门静脉重建	0(0)	1(2.86)
肝静脉重建	0(0)	1(2.86)
手术时间(min)^a	244.69±28.11	263.57±24.93	2.914	0.005^b
术中出血量(ml)^a	487.50±143.12	571.43±135.74	2.463	0.016^b
并发症
肺部感染	25(78.12)	28(80.00)	0.036	0.850^b
胸腔积液	19(59.38)	22(62.86)	0.085	0.770^b
胆漏	0(0)	5(14.29)	4.940	0.026^b
术区积液	11(34.38)	15(42.86)	0.506	0.477^b
术后住院时间(d)^a	10.56±1.27	11.80±1.84	3.171	0.002^b
术中情况与术前阅片满意度(分)^a	94.22±3.39	88.14±3.66	-7.038	<0.001^b
医患沟通满意度(分)^a	87.34±4.40	80.71±5.02	-5.726	<0.001^b

观察指标	研究组	对照组	统计值	P值
例数	32	35
手术方式中转	0(0)	5(14.29)	4.940	0.026^b
胆肠吻合	0(0)	2(5.71)
胆管吻合+T管引流	0(0)	1(2.86)
门静脉重建	0(0)	1(2.86)
肝静脉重建	0(0)	1(2.86)
手术时间(min)^a	244.69±28.11	263.57±24.93	2.914	0.005^b
术中出血量(ml)^a	487.50±143.12	571.43±135.74	2.463	0.016^b
并发症
肺部感染	25(78.12)	28(80.00)	0.036	0.850^b
胸腔积液	19(59.38)	22(62.86)	0.085	0.770^b
胆漏	0(0)	5(14.29)	4.940	0.026^b
术区积液	11(34.38)	15(42.86)	0.506	0.477^b
术后住院时间(d)^a	10.56±1.27	11.80±1.84	3.171	0.002^b
术中情况与术前阅片满意度(分)^a	94.22±3.39	88.14±3.66	-7.038	<0.001^b
医患沟通满意度(分)^a	87.34±4.40	80.71±5.02	-5.726	<0.001^b

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