Objective To investigate the accuracy of preoperative three-dimensional reconstruction of tumor in craniotomy for supratentorial convex brain tumors, and to provide an accurate and safe auxiliary method for craniotomy. Methods Patients with supratentorial convexity brain tumors who were admitted to the Department of Neurosurgery, West China Hospital, Yibin Hospital, Sichuan University between April 2018 and November 2020 were prospectively enrolled and randomly divided into reconstruction group and control group. In the reconstruction group, preoperative three-dimensional reconstruction of the tumor was used for craniotomy positioning, while in the control group, traditional two-dimensional tomographic imaging was used. The basic conditions, intraoperative localization and tumor exposure satisfaction rate, maximum diameter of bone window, operation time, cerebral draining vein injury, and postoperative subcutaneous effusion or intracranial infection were compared between the two groups. Results A total of 43 patients were included, 22 in the reconstruction group and 21 in the control group. There was no significant differences in age, gender composition, incidence of midline shift, tumor growth site and tumor size between the two groups (P>0.05). There was no significant difference in the incidence of cerebral drainage vein injury and postoperative subcutaneous effusion or intracranial infection between the two groups (P>0.05). The satisfaction rate of intraoperative positioning and tumor exposure in the reconstruction group (95.5% vs. 66.7%) was higher than that in the control group, the maximum diameter of the bone window [(6.26±1.32) vs. (7.31±1.13) cm] and the operation time [(194.00±22.76) vs. (214.57±26.53) min] were lower than the control group, and the differences were statistically significant (P<0.05). Conclusions Preoperative three-dimensional reconstruction helps to locate the tumor more accurately, improves the satisfaction rate of tumor exposure, reduces the diameter of the craniotomy window, and shortens the operation time. Compared with traditional two-dimensional tomographic positioning, it has more advantages.
ObjectiveTo study clinical practical value of multimode imaging technique in precise hepatectomy for huge hepatocellular carcinoma (HCC). MethodsThe clinicopathologic data of patients with huge HCC who underwent precise hepatectomy in Yuebei People’s Hospital from Jan. 2018 to Dec. 2020 were collected. The three-dimensional (3D) reconstruction, 3D visualization, 3D printing, and augmented reality (AR) were used to guide preoperative evaluation, surgical planning, and surgical navigation. The liver function indexes, surgical mode, operative time, intraoperative bleeding, volume of resected liver, postoperative hospitalization, and complications were analyzed. ResultsThere were 23 patients in this study, including 18 males and 5 females, with (56.8±8.1) years old. The virtual tumor volume assessed by multimodal imaging technology was (865.2±165.6) mL and the virtual resected liver volume was (1 628.8±144.4) mL. The planned operations were anatomical hepatectomy in 19 patients and non-anatomical hepatectomy in 4 patients. The actual operation included 17 cases of anatomical hepatectomy and 6 cases of non-anatomical hepatectomy, which was basically consistent with the results of AR. The operative time was (298.4±74.5) min, the median hepatic blood flow blocking time was 20 min, and the intraoperative bleeding was (330.4±152.8) mL. Compared with preoperative levels, the levels of hemoglobin and albumin decreased temporarily on the first day after operation (P<0.05), and then which began to rise on the third day and basically rose to the normal range; prothrombintime, total bilirubin, alanine aminotransferase, and aspartate aminotransferase increased transiently on the first day after operation (P<0.05), then which began to decline to the normal levels. There were no serious operative complications and no perioperative death. The median follow-up time was 18 months, the tumor recurrence and metastasis occurred in 3 cases. ConclusionFrom preliminary results of this study, it could improve surgical safety and precision of hepatectomy for huge HCC by preoperative precise assessment and operation navigation in good time of multimode imaging technology.
ObjectiveTo review the research progress of digital occlusion setup in orthognathic surgery. Methods The literature related to digital occlusion setup in orthognathic surgery in recent years was consulted, and the imaging basis, methods, clinical applications as well as existing problems were reviewed. Results Digital occlusion setup in orthognathic surgery includes manual, semi-automatics, and fully automatic methods. The manual method mainly relies on visual cues for operation, which is difficult to ensure the best occlusion set up, though relatively flexible. The semi-automatic method utilizes the computer software for partial occlusion set up and adjustment, but the occlusion result is still largely depended by manual operation. The fully automatic method completely depends on the operation of computer software, and targeted algorithms for different occlusion reconstruction situations are needed. Conclusion The preliminary research results have confirmed the accuracy and reliability of digital occlusion setup in orthognathic surgery, but there are still some limitations. Further research is needed in terms of postoperative outcomes, doctor and patient acceptance, planning time and cost-effectiveness.