计算机辅助手术系统在儿童腹部肿瘤破裂手术中的应用

Application of Computer-Assisted Surgical System in Children’s Ruptured Abdominal Tumor Surgery

摘要: 目的：探讨HisenseCAS计算机辅助手术系统在儿童腹部肿瘤破裂手术中的应用优势。方法收集2012年1月至2024年1月期间于青岛大学附属医院小儿外科行手术治疗的24例腹部肿瘤破裂患儿的临床资料，根据术前是否应用HisenseCAS计算机手术辅助系统分为三维重建组(13例，54.17%)和二维CT组(11例，45.83%)。对2组患儿的基本信息和手术相关信息进行对比并进行统计学分析，比较计算机辅助三维成像与二维影像对手术规划的影响。结果：本研究中的24例患儿均通过开腹手术方式切除肿瘤，术中探查及术后病理均证实肿瘤存在破裂出血。三维重建组与二维CT组患儿性别、年龄、身高、体重、术前血红蛋白、肿瘤最大直径均无统计学意义(均P > 0.05)，三维重建组患儿的手术时长短于二维CT组(P = 0.018)，三维重建组患儿的术中出血量少于二维CT组(P = 0.008)，三维重建组患儿的术后腹腔引流管拔管时间短于二维CT组(P < 0.001)，三维重建组患儿的术后住院天数短于二维CT组(P = 0.003)，2组患儿术后肿瘤复发或转移率无统计学意义(P > 0.05)。三维重建组医生术前根据三维重建图像进行的手术模拟与术中实际探查情况相符。结论：儿童腹部肿瘤破裂少见且发病急骤，且肿瘤体积往往较大，易发生低血容量性休克，手术探查止血效果良好，但术前规划难度较高，HisenseCAS计算机辅助手术系统的3D可视化技术能补充CT检查结果，对腹部肿瘤破裂患儿的术区情况进行术前重建，完善患儿的术前评估，辅助医师设计手术方案，术中进行导航，提高手术的精准性和安全性，为腹部肿瘤破裂患儿的治疗和预后提供保障。

Abstract: Objective: Exploring the application advantages of the HisenseCAS computer-aided surgical system in pediatric abdominal tumor rupture surgery. Methods: Collect clinical data of 24 children with abdominal tumor rupture who underwent surgical treatment at the Pediatric Surgery Department of Qingdao University Affiliated Hospital from January 2012 to January 2024. They were divided into a 3D reconstruction group (13 cases, 54.17%) and a 2D CT group (11 cases, 45.83%) based on whether the HisenseCAS computer-assisted surgical system was used before surgery. Compare the basic information and surgical related information of two groups of children and conduct statistical analysis to compare the impact of computer-aided 3D imaging and 2D imaging on surgical planning. Results: In this study, all 24 children underwent open surgery to remove the tumor, and intraoperative exploration and postoperative pathology confirmed the presence of tumor rupture and bleeding. There was no statistically significant difference in gender, age, height, weight, preoperative hemoglobin, and maximum tumor diameter between the 3D reconstruction group and the 2D CT group (both P > 0.05). The duration of surgery in the 3D reconstruction group was longer than that in the 2D CT group (P = 0.018), and the intraoperative blood output in the 3D reconstruction group was lower than that in the 2D CT group (P = 0.008). The postoperative time for removing the abdominal drainage tube in the 3D reconstruction group was shorter than that in the 2D CT group (P < 0.001). The postoperative hospital stay in the 3D reconstruction group was shorter than that in the 2D CT group (P = 0.003). There was no statistically significant difference in tumor recurrence or metastasis rates between the two groups (P > 0.05). The surgical simulation conducted by the 3D reconstruction team doctors based on the 3D reconstruction images before surgery is consistent with the actual exploration during the operation. Conclusions: Rupture of abdominal tumors in children is rare and occurs rapidly, and the tumor volume is often large, making it prone to hypovolemic shock. Surgical exploration and hemostasis have a good effect, but preoperative planning is difficult. The 3D visualization technology of the HisenseCAS computer-aided surgery system can supplement CT examination results, reconstruct the surgical area of children with abdominal tumor rupture before surgery, improve the preoperative evaluation of children, assist physicians in designing surgical plans, and perform navigation during surgery to improve the accuracy and safety of surgery, providing assurance for the treatment and prognosis of children with abdominal tumor rupture.