计算机辅助手术系统在小儿肾上腺区肿瘤切除中的应用研究 The Application of Hisense Computer-Assisted Surgery System (Hisense CAS) in the Surgical Treatment of Adrenal Tumors in Children
目的:探讨海信计算机辅助手术系统(Hisense CAS)在小儿肾上腺区肿瘤手术治疗中的应用。方法:青岛大学附属医院小儿外科2015~2019年收治的肾上腺区肿瘤患儿20例,均于术前行全腹增强CT检查,运用海信计算机辅助手术系统(Hisense CAS)在其增强CT图像的基础上行三维重建,术前制定详细手术计划,模拟切除肿瘤,术中实时指导。结果:20例手术治疗的患儿术前均行三维重建,实现术中精准切除肾上腺区肿瘤。术后随访6~12月,均未见肿瘤原位复发。结论:小儿肾上腺区域是12岁以下儿童常见肿瘤的发生部位,肿瘤毗邻重要脏器和血管。计算机手术辅助系统(Hisense CAS)能够在术前清晰直观立体地显示肾上腺中央静脉的位置及解剖特点以及肾上腺肿瘤与毗邻组织器官间的空间位置关系,可精准分析手术可行性,术前合理规划手术方案,对肾上腺肿瘤的精准手术切除有重要的指导意义。
Objective: To explore the value of Hisense computer-assisted surgery system (Hisense CAS) in the surgical treatment of adrenal tumors in children. Methods: A total of 20 children with adrenal tumors who were admitted to Department of Pediatrices in our hospital from 2015 to 2019 were enrolled. Contrast-enhanced CT was performed for all children, and based on the results of contrast-enhanced CT, the Hisense CAS was used for three-dimensional reconstruction, surgical planning, preoperative simulation of tumor resection, and intraoperative guidance. Results: All the 20 children underwent three-dimensional reconstruction of tumor, surrounding organs and blood vessels before operation, thus realizing accurate tumor resection during operation. All the 20 children showed no tumor recurrence in situ follow-up for 6 - 12 months. Conclusion: Adrenal region in children is the site of common tumors in children under 12 years old. Most of the tumors are adjacent to important organs and blood vessels. The computer assisted surgery system (Hisense CAS) can clearly, intuitively and stereoscopically display the location and anatomical characteristics of the adrenal central vein and the spatial positional relationship between adrenal tumors and adjacent tissues and organs before surgery. It can accurately analyze the feasibility of surgery, reasonably plan the surgical plan before surgery, and has important guiding significance for accurate surgical resection of adrenal tumors.
References
[1]
Brisse, H.J., Mccarville, M.B., Granata, C., et al. (2011) Guidelines for Imaging and Staging of Neuroblastic Tumors: Consensus Report from the International Neuroblastoma Risk Group Project. Radiology, 261, 243-257.
https://doi.org/10.1148/radiol.11101352
[2]
Lam, A.K. (2017) Update on Adrenal Tumours in 2017 World Health Organization (WHO) of Endocrine Tumours. Endocrine Pathology, 28, 213-227. https://doi.org/10.1007/s12022-017-9484-5
Henry, J.F., et al. (2000) Complications of Laparoscopic Adrenalectomy: Results of 169 Consecutive Procedures. World Journal of Surgery, 24, 1342-1346. https://doi.org/10.1007/s002680010222
[5]
Dunnick, N.R., et al. (1979) Computed Tomography in Adrenal Tumors. American Journal of Roentgenology, 132, 43-46. https://doi.org/10.2214/ajr.132.1.43
Li, H., et al. (2013) Construction of a Three-Dimensional Model of Renal Stones: Comprehensive Planning for Percutaneous Nephrolithotomy and Assistance in Surgery. World Journal of Urology, 31, 1587-1592.
https://doi.org/10.1007/s00345-012-0998-7
[12]
Chen, Y., et al. (2014) Surgical Planning and Manual Image Fusion Based on 3D Model Facilitate Laparoscopic Partial Nephrectomy for Intrarenal Tumors. World Journal of Urology, 32, 1493-1499.
https://doi.org/10.1007/s00345-013-1222-0
[13]
Ukimura, O., Nakamoto, M. and Gill, I.S. (2012) Three-Dimensional Reconstruction of Renovascular-Tumor Anatomy to Facilitate Zero-Ischemia Partial Nephrectomy. European Urology, 61, 211-217.
https://doi.org/10.1016/j.eururo.2011.07.068
[14]
Su, L., Zhou, X.J., Dong, Q., et al. (2015) Application Value of Computer Assisted Surgery System in Precision Surgeries for Pediatric Complex Liver Tumors. International Journal of Clinical and Experimental Medicine, 8, 18406-18412.