【摘要】 目的 研究3D打印技术在胸腔镜下肺段切除术中肺血管分支及手术并发症发生率评估方面的应用价值。方法 收集本院自2015年12月至2017年6月期间施行胸腔镜下肺段切除术共40例患者,所有患者术前均接受胸部高分辨增强CTA扫描重建3D打印模型,术中记录实际观察到的肺血管分支情况,临床数据采集包括手术时间、术中出血量、术后并发症等。结果 在所有40例接受术前3D打印模型重建的患者中,3D肺模型动脉分支与术中实际肺动脉分支符合率达到96.9%(94/97),肺静脉符合率高达98.5%(64/65),接受术前3D打印重建的患者术中出血量、手术时间及手术相关并发症发生率均明显减少(P<0.05)。术中未出现胸腔镜中转开胸的情况,术后30d或60d无死亡病例,随访3～12个月均未见肿瘤复发或转移。结论 3D打印技术能够清晰地显示术中肺血管的走向,对提高胸腔镜下肺段切除术的有效性和安全性方面起着重要作用。更多还原

【Abstract】 Objective To evaluate the effectiveness of application of 3D printing modeling in the assessment of pulmonary vessel branches and surgical complication on performing video-assisted thoracic surgery( VATS). Methods 40 consecutive patients underwent VATS lung segmentectomies were included in the study from December 2016 to June 2017. All of the patients had undergone preoperative 3D-CTA with 3-dimensional printing modeling. The actual pulmonary vessel branches by intraoperative findings were observed and various surgical outcomes, including total operative time, bleeding amount, the occurrence of postoperative complications were retrieved from clinical data. Results Among the 40 patients with preoperative 3D printing modeling, pulmonary artery branches wereprecisely identified for 96.9% ( 94/97) of branches on 3D printing model,and 98.5% ( 64/65) in Pulmonary vein branches. Patients with 3D printing modeling tended to have less intraoperative bleeding amount, operative time and the incidence rate of postoperative complications ( P<0.05). There was no conversion from VATS to thoracotomy, and there was no 30-day or 90-day mortalities or relapse of tumor within 3-12months after operations. Conclusion 3D printing modeling has the capability to clearly reveal the patterns of pulmonary vessels, which plays an important role in efficient and safety of VATS lung segmentectomies.更多还原