Abstract:

BACKGROUND: Multi-slice spiral CT and high-field MRI are often used in the precise treatment of the liver, to analyze the parameters related to liver parenchymal disease, Child-Pugh classification, portal hypertension and ICG retention rate. By using these two methods, reserve function of the residual liver can be relatively accurately evaluated, and safe limit of liver resection in individual patients can be determined.

OBJECTIVE: To investigate the clinical superiority of three-dimensional reconstruction technology in precision liver surgery.

METHODS: Randomly selected 100 primary liver cancer patients who had undergone resection at Liaoning Cancer Hospital & Institute in China were divided into a control group, in which two-dimensional CT examinations were used for empirical evaluation of tumor location, resection scope and residual liver volume and routine Pringle method was used for hepatic portal block intraoperatively, and an experimental group, in which three-dimensional reconstruction system was used preoperatively for stereoscopic imaging of intrahepatic conditions, perihepatic ducts and tumor traits and location, as well as for quantitative assessment of liver resection scope and residual volume, and selective hepatic occlusion was used intraoperatively. Postoperative liver resection volume and preoperative imaging evaluation were compared between groups, and postoperative recovery of patients was observed. The study protocol was implemented in line with the relevant ethical requirements of Liaoning Cancer Hospital & Institute. Participants and their families were fully informed of treatments and gave informed consent.

RESULTS AND CONCLUSION: Resected tumor volume and planned resection volume were insignificantly different in the experimental group, but significantly different in the control group (P < 0.05). Length of hospital and incidence of postoperative complications were significantly higher in the control group than the experimental group (P < 0.05). At 1 month postoperatively, the levels of serum insulin-like growth factor II, human transforming growth factor alpha, epidermal growth factor and alpha-fetoprotein were significantly decreased in the experimental group as compared with the control group (P < 0.05). The level of alanine aminotransferase tended to be normal in the experimental group relative to the control group at 14 days postoperatively. Postoperative abdominal drainage was gradually decreased in both two groups, but the drainage volume was significantly lower in the experimental group than the control group (P < 0.05). At 1 month postoperatively, the Karnofsky scores of the two groups were significantly higher than those preoperatively (P < 0.05), and the experimental group had significantly higher scores than the control group (P < 0.05). The total effective rate of the control group was significantly lower than that of the test group (92% vs. 100%; P < 0.05). To conclude, in contrast to traditional CT imaging technology, three-dimensional liver reconstruction technology can more accurately assess tumor volume before surgery, reduce intraoperative risks, shorten hospitalization time and reduce the incidence of postoperative complications. 

Key words:  Three-dimensional liver reconstruction, liver neoplasms, precision liver surgery, complications, liver volume