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

doi:10.3969/j.issn.1006-6233.2023.07.028

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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.

Key words： Augmented reality Laparoscopy Hepatectomy Coagulation Liver function Immunoglobulin

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	WU Yongrong
	LIU Zhen
	HAO Shuqing
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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[J]. HeBei Med, 2023, 29(7): 1201-1207.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.07.028 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I7/1201

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