影像学三维可视化技术指导肝切除术治疗肝细胞癌患者临床疗效研究*

doi:10.3969/j.issn.1672-5069.2024.03.030

Abstract

Abstract: Objective The aim of this study was to explore the clinical application of imaging three-dimensional visualization technique (3DVT) in guidance of hepatectomy in patients with hepatocellular carcinoma (HCC). Methods 63 patients with HCC were encountered in our hospital between January 2021 and December 2022, and were randomly divided into control (n=31) and observation group (n=32). All patients in the two groups underwent laparoscopic hepatectomy (LH) and the difference was in the control, the operation was carried out based on routine CT or MR imaging, while in the observation group, the LH was finished based on the 3DVT reconstruction. Serum interleukin-6 (IL-6), cortisol (Cor) and C-reactive protein (CRP) levels were detected by ELISA. Results The operation time, hepatic inflow occlusion time, intraoperative blood loss and hospital stay in the observation group were(190.6±44.1)min, (13.8±3.3)min, (310.5±87.2)mL and (10.8±2.9)d, all significantly shorter or less than [(228.3±56.9)min, (16.6±4.1)min,(399.2±96.92)mL and (13.3±3.5)d, respectively, P＜0.05] in the control; at the end of 7 days after operation, serum bilirubin, albumin levels and INR in the observation were (20.3±2.6)μmol/L, (38.2±3.9)g/L and (0.9±0.1), all not significantly different as compared to [(18.8±3.2)μmol/L, (37.6±4.4)g/L and (0.9±0.2)] in the control (P＞0.05); serum IL-6, Cor and CRP levels were (106.8±19.2)pg/ml, (260.1±35.4)mmol/L and (28.6±4.8)mg/L, all much lower than [(118.6±24.5)pg/ml, (291.6±40.7)mmol/L and (40.5±5.7)mg/L, respectively, P＜0.05] in the control; 3 months after surgery, the incidence of complications, such as infection, bile leakage and liver failure in the observation was 6.2%, much lower than 29.1%(P＜0.05) in the control group. Conclusion The advantage of LH under the guidance of 3DVT is terrific in patients with HCC, which could shorten operation time and hepatic inflow occlusion time, and is worthy of further clinical investigation.

Key words: Hepatocellular carcinoma, Hepatectomy, Three-dimensional visualization technique, Therapy

Yan Zhen, Zhao Bowen, Lin Guoying, et al. Clinical application of imaging three-dimensional visualization technique in guidance of hepatectomy in patients with hepatocellular carcinoma[J]. Journal of Practical Hepatology, 2024, 27(3): 438-441.

References

[1] Ding W, Yu J, Liu F, et al. Percutaneous microwave ablation versus robot-assisted hepatectomy for early hepatocellular carcinoma: a real-world single-center study. Dig Liver Dis, 2022, 54(2):243-250.
[2] Li C, He WQ. The impact of universal hepatitis B vaccine on the trend of liver cancer from the global burden of disease study 2017. Liver Int, 2021, 41(8):1762-1774.
[3] Yang SY, Yan ML, Duan YF, et al. Perioperative and long-term survival outcomes of laparoscopic versus laparotomic hepatectomy for bclc stages 0-A hepatocellular carcinoma patients associated with or without microvascular invasion: a multicenter, propensity score matching analysis. Hepatol Int, 2022, 16(4):892-905.
[4] Funamizu N, Ozaki T, Mishima K, et al. Evaluation of accuracy of laparoscopic liver mono-segmentectomy using the glissonian approach with indocyanine green fluorescence negative staining by comparing estimated and actual resection volumes: a single-center retrospective cohort study. J Hepatobiliary Pancreat Sci, 2021, 28(12):1060-1068.
[5] Fang C, An J, Bruno A, et al. Consensus recommendations of three-dimensional visualization for diagnosis and management of liver diseases. Hepatol Int, 2020, 14(4):437-453.
[6] Zhang B, Chen Z, Hu X, et al. Application of three-dimensional visualization technology in laparoscopic surgery for pheochromocytoma/paraganglioma: a single-center experience. J Laparoendosc Adv Surg Tech A, 2018, 28(8):997-1002.
[7] 刘永昌, 赵殿堂, 孙启峰, 等. 吲哚菁绿荧光导航和三维可视化腹腔镜精准手术治疗原发性肝癌患者应用研究. 实用肝脏病杂志, 2021, 24(4):561-564.
[8] Ushijima H, Kawamura J, Ueda K, et al. Visualization of lymphatic flow in laparoscopic colon cancer surgery using indocyanine green fluorescence imaging. Sci Rep, 2020, 10(1):14274.
[9] 中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌诊疗指南(2022年版). 中华肝脏病杂志, 2022, 30(4):367-388.
[10] Zheng R, Qu C, Zhang S, et al. Liver cancer incidence and mortality in China: temporal trends and projections to 2030. Chin J Cancer Res, 2018, 30(6):571-579.
[11] Liu Z, Xu K, Jiang Y, et al. Global trend of aetiology-based primary liver cancer incidence from 1990 to 2030: a modelling study. Int J Epidemiol, 2021, 50(1):128-142.
[12] 东贤进, 苏伟, 李连生, 等. 腹腔镜肝切除术与开腹肝切除术治疗肝内胆管细胞癌患者短期临床疗效研究. 实用肝脏病杂志, 2023, 26(1):120-123.
[13] Huang X, Chen Y, Shi X. Laparoscopic hepatectomy versus open hepatectomy for tumors located in right posterior segment: a single institution study. Asian J Surg, 2022, 45(1):110-116.
[14] Timaran Montenegro DE, Torres Ramirez CA, Mateo C YS, et al. CT-based hepatic residual volume and predictors of outcomes of patients with hepatocellular carcinoma unsuitable for surgical therapy undergoing transarterial chemoembolization. Acad Radiol, 2020, 27(6):807-814.
[15] Vasiniotis Kamarinos N, Sofocleous CT. Imaging and image-guided thermal ablation for oligometastatic colorectal cancer liver disease. Cancer J, 2020, 26(2):124-128.
[16] Chuang YH, Ou HY, Lazo MZ, et al. Predicting post-hepatectomy liver failure by combined volumetric, functional MR image and laboratory analysis. Liver Int, 2018, 38(5):868-874.
[17] 中华医学会数字医学分会, 中国医师协会肝癌专业委员会, 中国医师协会精准医学专业委员会, 等. 原发性肝癌三维可视化技术操作及诊疗规范(2020年版). 中华消化外科杂志, 2020, 19(9):897-918.
[18] Rhu J, Choi GS, Kim MS, et al. Image guidance using two-dimensional illustrations and three-dimensional modeling of donor anatomy during living donor hepatectomy. Clin Transplant, 2021, 35(1):e14164.
[19] Takenaka S, Chikazawa K, Yoshiizumi E, et al. Three-dimensional peripheral bloodstream model of the uterus for laparoscopic radical hysterectomy. J Minim Invasive Gynecol, 2020, 27(5):1196-1202.
[20] Chen Y, Bian L, Zhou H, et al. Usefulness of three-dimensional printing of superior mesenteric vessels in right hemicolon cancer surgery. Sci Rep, 2020, 10(1):11660.

Clinical application of imaging three-dimensional visualization technique in guidance of hepatectomy in patients with hepatocellular carcinoma

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