Study On The Application Of Digital Three-dimensional Reconstruction Model Based On CT Image Of Adrenal Tumor In Laparoscopic Adrenalectomy

Background and objectives:Adrenal tumor is one of the most common tumors in the urinary system.Laparoscopic adrenalectomy is characterized by small trauma and high safety,has become the gold standard procedure for adrenal tumors over the past years.However,infraoperative hemorrhage,as one of the severe complications of this procedure,has been found to be the major cause of conversion to open surgery,and thereby control of the central adrenal vein is often described as the key in laparoscopic adrenalectomy.To date,multiple techniques have been used for preoperative planning of laparoscopic adrenalectomy,such as computed tomography,MRI,intra-operative sonography,,but they are difficult to visualize the central adrenal vein.At present,digital 3D technology has been widely used in clinical medicine.However,there are few reports about the application of digital 3D reconstruction in adrenalectomy.To evaluate the clinical value of digital three-dimensional(digital 3D)model of adrenal tumor in laparoscopic adrenalectomy.Method40 patients with adrenal tumors at Zhujiang Hospital between January and June 2017 were selected retrospectively.According to the CT data,the digital 3D reconstruction model of adrenal tumor was performed by the Mimics 17.0 software before surgery and used for preoperative planning and intraoperative application among 20 patients(digital 3D model Group).We utilized CT data for surgical planning and intraoperative application among among 20 patients(CT Group).Patient demographics,surgical details,and postoperative treatment parameters were also analyzed.ResultLaparoscopic adrenalectomy was successfully performed in all the patients.Digital 3D models of adrenal tumor were successfully constructed for all the patients,by which the adrenal tumor,the central adrenal vein as well as adjacent organs were clearly visualized,with anatomical data accurately collected,including the location,length and thickness of the central adrenal vein.There were no major complications occurred,including injury to adjacent organs and major vessels.There are no differences between the two groups(CT Group versus digital 3D model Group)with regard to tumor size(2.16(1.15)cm versus 2.46(1.42)cm),blood loss(78.42(54.90)ml versus 69.47(18.24)ml),Patients in CT Group had significantly longer operative time than those in digital 3D model Group,with a mean(SD)of 71.31(22.29)min vs 59.47(11.65)min.ConclusionBy constructing digital 3D models for adrenal tumor,the central adrenal vein and the tumor as well as their adjacent organs can be optimally visualized,and the complex anatomical relationships between these structures be clearly revealed.Digital 3D reconstruction model of the adrenal tumor can be used in laparoscopic adrenalectomy safely and effectively and shorten the operative time.