Application Of Three-dimensional Visualization Technology In Hepatectomy: A Meta-analysis

Objective: This study systematically reviewed the global application of 3D vis-ualization technology in liver surgery through the collection of related clinical stud-ies published in domestic and foreign.The included articles were classified and de-eply analyzed to get a reliable comprehensive conclusion by strictly to evaluate th-e risk of bias and then to qualitative or quantitative synthesize the outcomes.To i-nvestigate the clinical effect of the application of 3D visualization technique in the diagnosis and treatment of liver tumor surgery.Methods: An electronical search was conducted in Pub Med,Embase,The Cochrane Library,SinoMed,CNKI,VIP a-nd Wan Fang Database to collect studies which compared the three-dimensional vi-sualization technology with conventional two-dimensional(2D)imaging technologie-s for liver resection from inception to September 2017.Two reviewers independent-ly screened literature,extracted data and assessed the risk bias of included studies and then RevMan 5.3 software was used to perform meta-analysis.Results: A tot-al of 11 studies involving 953 patients were included,of which 4 studies were no-n randomized controlled trials,7 studies were cohort studies,479 patients were in3 D group and 474 patients in 2D group.The results of meta-analysis showed that:the 3D group was superior to the control group in R0 resection rate [RR=1.14,95%CI(1.04,1.26),P=0.005];the incidence of postoperative complications of 3D group w-as lower than 2D group [RR=0.66,95%CI(0.51,0.86),P=0.002];the 3D group can si-gnificantly reduce the amount of blood transfusion in operation [MD=-96.05,95%CI(-126.78,-65.31),P<0.00001];the lower discrepancy range between the volume of the predicted liver resection and the actual resection volume [MD=-94.38,95%CI(-185.46,-3.30),P=0.04];a shorter operation time [MD=-33.58,95%CI(-60.09,-7.08),P=0.01];the lower intraoperative blood loss [MD=-79.70,95%CI(-139.86,-19.53),P=0.009].While there were no statistical differences between both groups of postoperative h-ospital stay time [MD=-0.75,95%CI(-2.45,0.95),P=0.39].In the subgroup analysis,it was found that hospitalization time of the patients with primary liver cancer in 3D group was less than the control group [MD=-2.00,95%CI(-3.08,-0.91),P=0.0003].Conclusions: The application of 3D visualization technique in liver surgery can bet-ter accurately predict the liver resection volume,improve the R0 resection rate,sh-orten the operation time,decrease intraoperative blood transfusion volume and the amount of bleeding,reduce the incidence of postoperative complications,shorten the hospitalized time in primary liver cancer patients.Due to limited quality and quantity of the included studies,the above conclusions are still needed to be verified by more high-quality studies.