Application Of 3D Visualization Technology Combined With Intraoperative Ultrasound In Laparoscopic Surgery For Primary Liver Cancer

Objective:To study the application of 3D visualization technology to construct liver digital model before surgery,combined with real-time guidance of intraoperative ultrasound technology in laparoscopic surgery for primary liver cancer.Methods:The clinical data of 89 patients with primary liver cancer treated in the Department of Hepatobiliary surgery,the first affiliated Hospital of Bengbu Medical College from October 2020 to March 2022 were analyzed retrospectively.According to the preoperative three-dimensional reconstruction of the liver and intraoperative ultrasound guidance,the patients were divided into two groups: the study group(n=47)and the control group(n=42).The patients in the control group received routine two-dimensional imaging examination before operation,and the patients in the study group received routine two-dimensional imaging examination,and the two-dimensional image data were input into the three-dimensional reconstruction system before operation,and the three-dimensional visualization technology was used to construct the digital model of the liver.Through the reconstructed three-dimensional image of the liver,we can more intuitively grasp the liver structure,the spatial location of the focus and whether there is peripheral metastasis and infiltration,etc.implement the concept of accurate hepatectomy and design the pre-operation plan before operation.laparoscopic ultrasound guidance was performed during the operation.The mode of operation,intraoperative blood loss,intraoperative blood transfusion,intraoperative hilar occlusion time,operation time,incidence of postoperative complications,postoperative hospital stay,one-year recurrence rate and survival rate were collected from the two groups.Results:All the 89 patients completed the surgical treatment successfully,the pathological description of the specimens was hepatocellular carcinoma or adenocarcinoma of the liver,and there was no positive margin.In the control group,35 patients underwent laparoscopic hepatectomy according to the preoperative plan,and 7 patients were converted to open hepatectomy.Forty-seven patients in the study group underwent laparoscopic hepatectomy according to preoperative planning and laparoscopic ultrasound guidance,and there was no conversion to laparotomy,while in the study group,32 patients underwent laparoscopic lobectomy / segmental hepatectomy and 7patients underwent laparoscopic local hepatectomy.In the control group,8 cases underwent laparoscopic lobectomy / segmental hepatectomy and 20 cases underwent laparoscopic local hepatectomy.There was significant difference between the two groups(P<0.05).The intraoperative blood loss,hilar occlusion time,blood transfusion rate and operation time in the study group were significantly lower than those in the control group(P<0.05).The incidence of postoperative complications and postoperative hospitalization time in the study group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).The one-year tumor recurrence rate in the study group was significantly lower than that in the control group(P<0.05).There was no significant difference in survival rate between the two groups(P > 0.05).Conclusion:The application of preoperative three-dimensional visualization technology combined with intraoperative ultrasonic guidance in laparoscopic hepatectomy for primary liver cancer has created favorable conditions for the realization of accurate hepatectomy,which can develop individualized surgical plans,reduce intraoperative bleeding and blood transfusion,effectively reduce the duration of porta hepatis occlusion,reduce the duration of surgery,reduce the incidence of postoperative complications and shorten the duration of postoperative hospitalization,with significant therapeutic effects.It has important guiding significance for laparoscopic hepatectomy.