To explore the clinical significance of CT three-dimensional reconstruction visualization system for surgical planning and intraoperative guidance for primary liver cancer (PLC).

Clinical data of 46 patients with PLC admitted to Chinese PLA General Hospital from March 2016 to March 2017 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. All patients were divided into the visualization (n=23) and control groups (n=2). In visualization group, 18 patients were male and 5 were female with an average age of (61±9) years. In control group, 16 cases were male and 7 were female, aged (60±9) years on average. All patients were diagnosed with liver cancer before operation. In visualization group, CT D reconstruction visualization system was used for accessing the condition of patients before operation. The surgical procedure, operation time, intraoperative blood loss and postoperative complications of two groups were observed. The operation time and intraoperative blood loss were compare by t test. The rate comparison was conducted by Chi-square test. Correlation analysis was performed by Pearson correlation analysis.

D reconstruction visualization system could precisely display the relationship between tumors and vasculature and identify the anatomical variations. In visualization group, the percentage of undergoing minimally invasive surgery was 48% (11/23), significantly higher than 17% (4/23) in control group (χ2=4.85, P<0.05). In visualization group, the intraoperative operation time, blood loss and length of hospital stay were (128±38) min, (135±67) ml and (7.7±2.3) d, significantly less than (205±56) min, (270±83) ml and (10.9±2.0) d in control group (t=-5.37, -3.31, -4.92; P<0.05). The postoperative levels of ALT and TB in visualization group were (205±96) U/L and (12.2±2.4) μmol/L, significantly lower than (302±136) U/L and (18.5±3.8) μmol/L in the control group (t=-2.81, -6.67; P<0.05). In visualization group, the estimated volume of resected liver before operation was (483±30) ml, where no significant difference was observed compared with the actual intraoperative resected liver volume (437±30) ml (t=1.13, P>0.05), and a positive correlation was observed between them (r=0.814, P<0.05).

CT D reconstruction visualization system is useful for preoperative safety assessment, locating the key anatomical parts, optimizing surgical plans so as to conduct the precise hepatectomy.