| Objective: Because of the unique characteristics of huge tumor and multiple involvement of hilar,children’s liver tumors need more accurate surgical resection than adults.Precise liver tumor surgery can preserve more residual liver volume on the basis of complete resection of liver tumor,which is conducive to the postoperative recovery of children.By analyzing and summarizing the clinical application of Computer aided surgery system(Hisense CAS)in precision surgery of liver tumors in children,it can be found that accurate three-dimensional reconstruction of liver tumors is more conducive to the implementation of precision liver surgery.Methods: The complete medical records of 82 children who were admitted to a hospital and underwent surgical resection in our hospital from January 2013 to September2021 were collected.All children included in the study underwent two-dimensional enhanced CT before operation,and three-dimensional reconstruction was performed with Hisense CAS computer-aided surgery system.To compare the differences between two-dimensional enhanced CT and three-dimensional reconstruction model in the selection of treatment scheme,operation scheme design and planning of children.SPSS26.0 was used to make statistics on the clinical data of all children,such as age,height,weight,operation time,intraoperative bleeding and postoperative hospital stay.The operable rate and revision rate of surgical scheme of two-dimensional enhanced CT and three-dimensional reconstruction model were compared.The differences of operable rate and revision rate of surgical scheme between two-dimensional enhanced CT and Computer aided surgery system(Hisense CAS)were statistically analyzed.Results: Among the 82 children with liver tumors,9 cases were judged to be unable to undergo surgical resection through two-dimensional enhanced CT images,while the three-dimensional reconstruction of Computer aided surgery system(Hisense CAS)was used to judge that the children were feasible for surgical treatment.The operability rate of children after three-dimensional reconstruction was 10.98% higher than that of two-dimensional enhanced CT images.82 children with liver tumors were planned with two-dimensional enhanced CT before operation,and then the operation was planned based on the three-dimensional reconstruction model of Hisense CAS computer-aided operation system.The operation scheme of 30 children was different from that formulated under two-dimensional enhanced CT,and the revision rate of the operation scheme was36.59%.Conclusion: The use of three-dimensional reconstruction of Computer aided surgery system(Hisense CAS)is conducive to accurately judge the tumor location and vascular variation before operation,to clarify the adjacent relationship between the tumor and the surrounding adjacent blood vessels,tissues and organs,to accurately judge whether the precise liver operation is feasible for children with liver tumors,and to help clinicians make decisions on the treatment plan for children with liver tumors.It is more conducive for pediatric surgeons to design and formulate the operation plan for children with liver tumors and how to better implement accurate liver tumor resection.Surgeons should reserve more liver tissue,protect the bile duct and avoid damaging important blood vessels and organs for children as much as possible during the operation,so that more liver tissue can better meet the needs of postoperative liver body compensation,and protect the bile duct tissue and fine operation during the operation.It can reduce the incidence of postoperative biliary fistula and other complications,shorten the postoperative recovery time of children,accelerate the postoperative recovery of children with liver tumors,and have a good prognosis.Objective: Postoperative recurrence of primary hepatocellular carcinoma(HCC)is an important factor affecting the survival rate of patients.Moreover,HCC patients have high early recurrence rate,low 5-year survival rate and poor overall prognosis.This study is mainly based on pathological analysis to screen the relevant characteristics of early postoperative recurrence(within 2 years)and recurrence of hepatocellular carcinoma,and establish a recurrence prediction model to predict early postoperative recurrence and recurrence.Methods: The data of 279 patients with primary hepatocellular carcinoma were analyzed retrospectively.The characteristics related to early postoperative recurrence and recurrence in pathological sections were extracted by artificial intelligence histopathology,and the pathological characteristics closely related to early recurrence and recurrence were screened by lasso and other methods.The recurrence prediction model was established by directly applying the relevant pathological characteristics,and the performance of the model was evaluated by the accuracy,sensitivity,specificity and area under the curve(AUC)evaluation of the recurrence prediction model.The clinical data of84 patients and the predicted values obtained from the recurrence prediction model were selected to analyze the prognosis of patients with primary hepatocellular carcinoma.The grouped information was analyzed by Kaplan Meier survival analysis and Cox regression analysis using SPSS 26.0.Results: The accuracy,sensitivity,specificity and area under the curve(AUC)of the prediction model of early postoperative recurrence in 86 patients with hepatocellular carcinoma based on artificial intelligence histopathology were 0.77,0.85,0.73 and 0.75 respectively.The accuracy,sensitivity,specificity and area under the curve(AUC)of the recurrence prediction model in 193 patients with hepatocellular carcinoma were 0.79,1.0,0.57 and 0.90 respectively.Through Kaplan Meier survival analysis and Cox regression analysis of the clinical data and recurrence prediction values of 84 patients with hepatocellular carcinoma,it can be concluded that the prediction values of gender,tumor diameter,number of lesions,MVI and recurrence prediction model are important factors affecting the prognosis of patients with hepatocellular carcinoma,and the prediction values of gender,tumor diameter,number of lesions and recurrence prediction model are independent risk factors for postoperative recurrence of patients with hepatocellular carcinoma.Conclusion: The prediction model is established based on the pathological characteristics of early postoperative recurrence and recurrence of hepatocellular carcinoma,which provides a new way to predict early postoperative recurrence and recurrence.This study obtains four independent risk factors of recurrence,such as gender,tumor diameter,number of lesions and the prediction value of recurrence prediction model.Five important prognostic factors such as MVI and the predicted value of recurrence prediction model can help clinicians quickly and accurately judge the postoperative recurrence risk of patients with hepatocellular carcinoma,help clinicians screen high-risk patients with early postoperative recurrence and recurrence,provide personalized and accurate schemes for postoperative comprehensive treatment of patients with hepatocellular carcinoma,and implement early intervention measures for high-risk patients to minimize postoperative recurrence and prolong the survival time of patients. |
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