计算机辅助手术系统(Hisense CAS)在小儿肾肿瘤手术治疗中的应用研究

Application of Computer-Assisted Surgery System (Hisense CAS) in the Surgical Treatment of Pediatric Renal Tumors

摘要: 目的：探讨海信计算机辅助手术系统(Hisense CAS)在小儿肾肿瘤手术治疗中的应用。方法：回顾性分析2017年1月至2022年6月青岛大学医学院附属医院小儿外科收治的11例肾肿瘤患儿的临床资料，利用海信计算机辅助手术系统对患儿腹部、盆腔薄层断层扫描图像对泌尿系统进行三维重建，并在此基础上进行术前规划，通过术前三维重建影像，手术医师可以更清晰地了解肾肿瘤的位置、大小，肾脏周围动脉、静脉的走行、分支及毗邻关系等，判断手术的可行性及规划手术方案，预测术中情况，分析手术时间、术中出血量、并发症等。结果：11例肾肿瘤患儿CAS三维重建结果清晰显示肾肿瘤的位置、大小、毗邻关系及瘤肾周围血管的走行、分支等。11例重复肾患儿中，右侧2例，左侧8例，双侧1例；11例均行单侧瘤肾及输尿管切除术；手术时间65~300 min，平均为130.55 min，术中平均出血量18.36 mL，最少出血量为2 mL。11例术后平均拔管时间为术后平均2天，术后平均住院时间10 d，均痊愈出院。结论：利用海信计算机辅助手术系统，对传统CT及增强CT检查后的影像学图像进行二次处理后三维重建，并以此为依据辅助设计最优手术方案，可提高小儿肾肿瘤手术治疗的准确性、安全性。

Abstract: Objective: To investigate the application of Hisense Computer Assisted Surgery System (Hisense CAS) in the surgical treatment of pediatric renal tumors. Methods: The clinical data of 23 children with renal tumors admitted to the Affiliated Hospital of Qingdao University School of Medicine from January 2017 to June 2022 were retrospectively analyzed. CT three-dimensional reconstruction and preoperative planning can accurately determine the location and size of renal tumors, the course, branches and adjacent relationship of the vascular system around the kidney, the course of the ureter, the stenosis, etc., to determine the feasibility of the operation and the operation plan, and to analyze the operation time, intraoperative bleeding volume, blood transfusion rate, complications, etc. Results: The CAS three-dimensional reconstruction results of 11 children with renal tumors clearly showed the location, size, adjacent relationship of renal tumors, and the course and branches of blood vessels around the tumor and kidneys. Among the 11 children with duplication kidney, 2 cases were on the right side, 8 cases were on the left side, and 1 case was bilateral; all 11 cases underwent unilateral tumor nephrectomy and ureterectomy; the operation time was 65~300 minutes, with an average of 130.55 minutes. The average blood loss was 18.36 mL, and the minimum blood loss was 2 mL. The average postoperative extubation time of the 11 cases was 2 days and the average postoperative hospital stay was 10 days. All of them were cured and discharged. Conclusion: Using the Hisense computer-aided surgery system can improve the accuracy and safety of pediatric renal tumor surgery by performing three-dimensional reconstruction of the data after traditional CT examination and assisting in designing the optimal surgical plan.