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| Preoperative Three-Dimensional Reconstruction of the Liver Applied to Precision Resection of Primary Hepatocellular Carcinoma |
| ZHANG Yong, FAN Bin, LI Qinghe |
| Enshi Central Hospital, Hubei Enshi 445000, China |
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Abstract Objective: To investigate the impact of preoperative liver reconstruction in accurate resection for primary liver cancer. Methods: From January 2019 to January 2022, a total of 107 patients were admitted to our hospital. Patients were grouped by computer random numbers: Excel was used to generate 107 random numbers, each corresponding to a patient, and the first 53 numbers were assigned to the control group, and the remaining 54 numbers to the research group according to the order of the generated random numbers from smallest to largest. In the control group (n=53), conventional preoperative evaluation was performed based on conventional two-dimensional imaging of the liver, and in the study group (n=54), preoperative evaluation was performed by applying three-dimensional reconstruction of the liver, and the clinical indexes, hepatic resection volume, liver function indexes, and the levels of serum glycoantigen 19-9 (CA19-9), insulin-like growth factor 1 (IGF-1), carcinoembryonic antigen (CEA), and alpha-fetoprotein (AFP) of the patients in the two groups were compared. ) and alpha-fetoprotein (AFP) levels, and postoperative complications were recorded. The patients were followed up for 1 year and their recurrence metastasis and death were recorded. Results: There was no significant difference in operation time and blood transfusion rate between the two groups (P>0.05). Compared with the control group, the amount of blood loss during operation in the study group was reduced, and the length of hospital stay and anal exhaust time were shortened (P<0.05). There was no significant difference in the actual resected liver volume between the two groups (P>0.05). The preoperative measurement value of the study group was lower than that of the control group, and the actual resected liver volume ratio was higher than that of the control group (P<0.05). There was no significant difference in liver function indexes between the two groups before surgery (P>0.05). There were statistically significant differences in postoperative liver function indexes between the two groups, with AST, ALT, TBIL and AFP levels decreased and ALB levels increased, and the increase and decrease of patients in the study group was greater than that in the control group (P<0.05). There was no significant difference in serum levels of lGF-1, CEA, CA19-9 and AFP between 2 groups before surgery (P>0.05). After treatment, the serum levels of lGF-1, CEA, CA19-9 and AFP were all decreased, and the increase and decrease of patients in the study group were greater than those in the control group (P<0.05). In the control group, there were 1 case of biliary leakage, 4 cases of wound infection, 3 cases of pulmonary infection, and 3 cases of abdominal effusion. The total complication rate was 20.75% (11 cases /53 cases), and there were 8 cases of recurrence and metastasis (15.09%). In the study group, there were 2 cases of pulmonary infection, 1 case of wound infection and 1 case of abdominal effusion, the total complication rate was 7.41% (4 cases /54 cases), and there were 2 cases of recurrence and metastasis (3.70%). The incidence of postoperative complications (7.41%) and recurrence and metastasis (3.70%) in the study group were lower than those in the control group (20.75%, 15.09%), and the differences were statistically significant (P<0.05). Conclusion: Three-dimensional preoperative liver reconstruction technology can improve the accuracy and safety of primary liver cancer resection, reduce the risk of complications after surgery, reduce the damage to their liver function, and has a broad application prospect and high clinical application value.
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2023, Vol. 29 
