Application of liver three-dimensional visualized reconstruction technique in hepatectomy for children with complicated hepatoblastoma
10.3969/j.issn.1001-5256.2021.09.025
- VernacularTitle:肝脏三维可视化重建技术在儿童复杂肝母细胞瘤肝切除术中的应用价值
- Author:
Di ZHAO
1
;
Jindong YE
1
;
Huali LI
1
;
Kui JIN
1
;
Xiang LIU
1
;
Xiaoran LI
1
;
Liuxin DUAN
1
;
Jungui LIU
1
;
Wei LYU
1
;
Weihong DUAN
1
;
Quanda LIU
1
Author Information
1. Department of Hepatobiliary Surgery, Research Institute of Hepatobiliary and Gastrointestinal Diseases, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
- Publication Type:Original articles_Liver neoplasms
- Keywords:
Hepatoblastoma;
Hepatectomy;
Imaging, Three-Dimensional;
Child
- From:
Journal of Clinical Hepatology
2021;37(9):2130-2135
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the application of liver three-dimensional (3D) visualized reconstruction technique in hepatectomy for children with complicated hepatoblastoma. Methods A retrospective analysis was performed for the clinical data of 30 children with hepatoblastoma who underwent hepatectomy for radical resection in PLA Rocket Force Characteristic Medical Center from January 2018 to October 2020, and according to whether liver 3D visualization with IQQA-Liver system was performed before surgery, the children were divided into 3D reconstruction group with 15 children and control group with 15 children. The two groups were compared in terms of perioperative parameters, short-term prognosis, and follow-up conditions. The independent samples t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the Fisher's exact test was used for comparison of categorical data between two groups. Results Compared with the control group, the 3D reconstruction group had a significantly higher mean age (55.7±10.2 years vs 28.2±2.7 years, P < 0.05) and a significantly higher number of patients with POSTTEXT stage III/VI hepatoblastoma (12 vs 5, P < 0.05) or involvement of the hepatic vein or the inferior vena cava (11 vs 3, P < 0.05). All children completed the surgery successfully, and there were no significant differences between the two groups in blood loss, time of operation, number of times and duration of hepatic portal occlusion, and number of children receiving segmental hepatectomy or partial hepatectomy (all P > 0.05). The median follow-up after surgery was 9.5 months. In the 3D reconstruction group, 2 children experienced recurrence and were diagnosed at 10 and 12 months, respectively, after surgery, and they were treated with chemotherapy at the moment; in the control group, 4 children experienced recurrence, which was higher than that in the 3D reconstruction group ( P =0.651), and among these 4 children, 2 had recurrence at 7 months after surgery, received liver transplantation, and survived up to now, and the other 2 children died shortly after recurrence. Conclusion 3D visualized reconstruction technique helps to perform hepatectomy for children with complicated hepatoblastoma more safely and accurately, especially extended hepatectomy for patients with stage POST TEXT III/IV hepatoblastoma, thereby avoiding liver transplantation.
