Application of 3D visualization and 3D printing in resection of complex liver tumors

doi:10.3877/cma.j.issn.2095-3232.2021.04.007

Abstract

Abstract:

Objective

To evaluate the application of 3D visualization and 3D printing in the diagnosis and treatment of complex liver tumors.

Methods

Clinical data of 30 patients with complex liver tumors admitted to General Hospital of Ningxia Medical University from January 2016 to October 2019 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 20 patients were male and 10 female, aged 24-74 years with a median age of 51 years. Abdominal enhanced CT scan was performed before operation. 3D reconstruction was carried out using 3D visualization system. 1:1 physical model was constructed by 3D printer. Prior to operation, the relationship between tumors and surrounding vessels was analyzed through the 3D images and physical model. Simulated resection was performed and individualized diagnosis and treatment regimes were designed. Operative conditions and postoperative complications were observed. The simulated resected liver volume was compared with the actual resected liver volume by t test.

Results

3D reconstructions of all the patients were completed, and 3D printed models of 10 cases were obtained. The intrahepatic vessels of grade Ⅲ and above were reconstructed. The relationship among the 3D anatomical morphology, location of tumors and its relation with the surrounding blood vessels could be explicitly displayed. 3 patients were with hepatic artery variations, 4 cases with hepatic vein variations and 2 cases with portal vein branches invaded by tumors. The mean liver volume was (1 779±325) ml, and the liver tumor volume was (572±238) ml. The consistency rate between preoperative simulated surgery and the actual surgery was 100%(30/30). The simulated resected liver volume was (896±405) ml, which did not differ from (815±270) ml of the actual resected liver volume (t=0.205, P>0.05). The operation time was (288±66) min, intraoperative blood loss was (722±390) ml, and the length of hospital stay was (20±6) d. Postoperative pleural effusion occurred in 10 patients and bile leakage in 3 cases. No perioperative death, massive bleeding, liver failure or other severe complications were observed.

Conclusions

3D visualization and 3D printing is precise, safe and effective in preoperative design and resection of complex liver tumors.

Key words: Liver neoplasms, Hepatectomy, Imaging, three-dimensional

Peng Lei, Xiaodong Xie, Chaofeng Tang, Yubo Zhang, Xiaohu He, Songning Yu. Application of 3D visualization and 3D printing in resection of complex liver tumors[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2021, 10(04): 371-375.

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References 21

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