1.Three dimensional reconstruction of the liver and the abdominal blood vessels based on the 64-slice spiral CT data
Xinyong ZHU ; Chihua FANG ; Peifeng JIAO ; Xianyue QUAN ; Hailiang TANG ; Susu BAO ; Shizhen ZHONG
Chinese Journal of Digestive Surgery 2008;7(4):273-276
Objective To explore the accuracy and practical significance of the 3-dimensional (3D) reconstruction of the liver and the abdominal blood vessels based on the data of 64-slice spiral computerized tomography (64S-SCT). Methods The 2D images of the liver and the abdominal blood vessels were collected after TLC-scanning with 64S-SCT. The 3D images of the liver, hepatic internal duct system and the abdominal blood vessels were reconstructed by the medical image processing system. The volume of the 3D reconstructed liver was compared with that of the actual liver measured by the 64S-SCT, and the portal vein of the reconstructed liver model was compared with that reconstructed by the Mxview workstation based on the 64S-SCT data. Results The 3D models of the liver, hepatic internal duct system and abdominal blood vessels were vivid, and could be revolved and observed at any direction. The spatial relationship among main intrahepatic ducts was clearly displayed. The actual liver volume and the condition of the intrahepatic ducts were accurately demonstrated. The reconstructed liver, the branches of the hepatic artery and portal vein, and the abdominal blood vessels were simultaneously displayed by adjusting the transparency of the liver model. The portal vein of the reconstructed liver model completely matched that reconstructed by the Mxview workstation based on the 64S-SCT data. Conclusions The 3D models of the liver, hepatic internal duct system and abdominal blood vessels reflect the human anatomy structure, and provide reliable virtual organs and vessel system for virtual liver surgery.
2.Clinical value of "four longitudinal, two transverse planes" method of membrane anatomy in laparoscopic radical cystectomy
Dongping BAO ; Peifeng ZHONG ; Guohao WU ; Haomin LI ; Dongjiang CHEN ; Xianguo HU ; Bingquan WU ; Zheng CHEN ; Zexiong GUO ; Dongming YE ; Caiyong LAI
Journal of Modern Urology 2024;29(5):399-405
【Objective】 To explore the clinical value of laparoscopic radical cystectomy based on fascia anatomy for bladder cancer treatment. 【Methods】 The clinical data of 51 patients with bladder cancer who underwent 3D laparoscopic radical cystectomy during Jan.2015 and Jun.2022 were retrospectively analyzed.The surgery was performed based on membrane anatomy technology along four longitudinal and two transverse planes to complete the radical cystectomy.The pelvic plexus was preserved for patients with normal preoperative sexual function. 【Results】 All surgeries were completed without conversion to open operation.The mean operation time was (502.52±108.99) min, mean intraoperative blood loss was (275.96±155.18) mL, mean postoperative drainage time was (4.14±2.41) d, and the mean postoperative hospital stay was (16.37±4.85) d.The mean number of lymph nodes removed was (17.98±11.48).The mean postoperative follow-up was (30.27 ±19.39) months.At the last follow-up, no Clavien ≥grade 3 complications were observed.The estimated overall survival (OS), tumor-specific survival (TSS), and recurrence-free survival (RFS) were 82.4%, 92.2%, and 88.2%, respectively.The lymph node positive patients had shorter OS and RFS (60.0%, 60.0%) than the lymph node negative patients (84.8%, 91.3%).Among the 19 male patients who underwent radical cystectomy with pre-exposure and preservation of pelvic plexus, daytime and nocturnal continence rate were 83.3% and 72.2%, respectively, and 17 patients recovered potency within 6 months postoperatively. 【Conclusion】 Laparoscopic radical cystectomy based on fascia anatomy is safe and effective in laparoscopic radical cystectomy, with standardized surgical procedure, satisfactory oncological outcomes, little hemorrhage, few complications and fast recovery.