Abstract:Objective: To investigate the value of augmented reality (AR) navigation combined with the seven-step,two-shot method in 3D laparoscopic reduction of the right hemicolectomy. Methods: A simple randomization method was used to divide 104 patients with hepatocellular carcinoma admitted to our hospital from January 2019 to January 2022 into a standard group and a modified group,with 52 patients in each group.The standard group underwent 3D laparoscopic right hemicolectomy,and the modified group underwent 3D laparoscopic reduced right hemicolectomy using AR navigation combined with the seven-step two-shot method.The two groups were compared in terms of the general condition of surgery,postoperative recovery process,hemoglobin,albumin,liver function[total bilirubin (TBil),glutamic aminotransferase (AST),glutamic aminotransferase (ALT)],coagulation function[prothrombin time (PT),prothrombin activity (PA),activated partial thromboplastin time (APTT),fibrinogen (FIB)],immunoglobulin[immune globulin G (IgG),IgA,IgM],complications and recurrence rate at 1 year follow-up. Results: The operation time,recovery time of postoperative bowel sounds,postoperative exhaustion time,postoperative bed activity time,postoperative tube placement time,and hospital stay were shorter in the modified group than in the standard group,and the intraoperative bleeding and actual volume of liver resection were lower than in the standard group,and the remaining liver volume was higher than in the standard group (P<0.05); hemoglobin,albumin,PA,and FIB were higher in the modified group than in the standard group at 3d and 5d postoperatively,and TBil,AST,ALT,PT,APTT were lower than those in the standard group (P<0.05).The IgG,IgA,and IgM at 3d and 5d postoperatively were higher in the modified group than in the standard group (P<0.05); the overall complication rate and recurrence rate at 1 year follow-up in the modified group were 1.92% (1/52) and 3.92% (2/51),respectively,which were not significantly different from 5.77% (3/52) and 8.00% (4/50) in the standard group (P>0.05). Conclusion: AR navigation combined with the seven-step,two-shot method can optimize the path of 3D laparoscopic reduction of right hemicolectomy,reduce intraoperative bleeding and hepatic resection volume,mitigate liver function and immune function damage,improve patients' coagulation function,and shorten patients' recovery process,with better safety and near- to mid-term results.
吴永融, 刘振, 郝树青, 韦敏. 增强现实导航联合七步两枪法用于3D腹腔镜缩小右半肝切除术中效果分析[J]. 河北医学, 2023, 29(7): 1201-1207.
WU Yongrong, LIU Zhen, HAO Shuqing, et al. Analysis of the Effect of AR Navigation Combined with the Seven-Step Two-Shot Method for 3D Laparoscopic Reduction of the Right Hemicolectomy. HeBei Med, 2023, 29(7): 1201-1207.
[1] Liu Z,Jiang Y,Yuan H,et al.The trends in incidence of primary liver cancer caused by specific etiologies:results from the global burden of disease study 2016 and implications for liver cancer prevention[J].Hepatol,2019,70(4):674-683. [2] Gorgec B,Benedetti Cacciaguerra A,Lanari J,et al.Assessment of textbook outcome in laparoscopic and open liver surgery[J].JAMA Surg,2021,156(8):212064. [3] Zhu W,Zeng XJ,Xiang N,et al.Application of augmented reality and mixed reality navigation technology in laparoscopic limited right hepatectomy[J].Chin Surg,2022,60(3):249-256. [4] 孔都.模式化腹腔镜右半肝切除术的技术要点及临床应用研究[D].山东:山东大学,2019. [5] 张成雷.可手术乳腺癌患者的循环肿瘤细胞与凝血功能及病理特征的关系研究[J].中国医学创新,2019,16(19):62-65. [6] 中国抗癌协会肝癌专业委员会,中华医学会肝病学分会肝癌学组,中国抗癌协会病理专业委员会,等.原发性肝癌规范化病理诊断指南(2015年版)[J].临床肝胆病杂志,2015,31(6):833-839. [7] 中华人民共和国国家卫生健康委员会医政医管局.原发性肝癌诊疗指南(2022年版)[J].中华消化外科杂志,2022,21(2):143-168. [8] Bartha E,Ahlstrand R,Bell M,et al.ASA classification and surgical severity grading used to identify a high-risk population,a multicenter prospective cohort study in Swedish tertiary hospitals[J].Acta Anaesthesiol Scand,2021,65(9):1168-1177. [9] Groeneveld D,Cline-Fedewa H,Baker KS,et al.Von willebrand factor delays liver repair after acetaminophen-induced acute liver injury in mice[J].Hepatol,2020,72(1):146-155. [10] 罗圆圆,汪德清,周玲玲,等.体外大剂量失血/输血模型的建立及不同大剂量输血策略对模型凝血功能的影响[J].中国输血杂志,2021,34(6):599-603. [11] Goikoetxea-Usandizaga N,Serrano-Macia M,Delgado TC,et al.Mitochondrial bioenergetics boost macrophage activation,promoting liver regeneration in metabolically compromised animals[J].Hepatology,2022,75(3):550-566. [12] Horton MB,Hawkins ED,Heinzel S,et al.Speculations on the evolution of humoral adaptive immunity[J].Immunol Cell Biol,2020,98(6):439-448. [13] 陈加新,胡嵩,陈怡发,等.腹腔镜肝切除术对原发性肝癌患者免疫球蛋白及VEGF aFGF水平的影响[J].河北医学,2022,28(4):604-608.