Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2015; 21(35): 10200-10207
Published online Sep 21, 2015. doi: 10.3748/wjg.v21.i35.10200
Application of 3D reconstruction for surgical treatment of hepatic alveolar echinococcosis
Yi-Biao He, Lei Bai, Tuerganaili Aji, Yi Jiang, Jin-Ming Zhao, Jin-Hui Zhang, Ying-Mei Shao, Wen-Ya Liu, Hao Wen
Yi-Biao He, Lei Bai, Tuerganaili Aji, Jin-Ming Zhao, Jin-Hui Zhang, Ying-Mei Shao, Hao Wen, Liver and Laparoscopic Surgery Department, Digestive and Vascular Surgery Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uyghur Autonomous Region, China
Yi Jiang, Wen-Ya Liu, Medical Imaging Research Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uyghur Autonomous Region, China
Author contributions: He YB, Wen H, Zhao JM and Zhang JH designed the research; He YB, Bai L, Aji T and Jiang Y collected the data and performed the research; He YB, Bai L and Aji T analyzed the data; He YB and Bai L wrote the paper; Wen H, Zhao JM, Zhang JH, Shao YM and Liu WY revised the paper.
Supported by National Natural Science Foundation of China, No. 81160201 and No. U1303222.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Xinjiang Medical University.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hao Wen, Professor, Liver and Laparoscopic Surgery Department, Digestive and Vascular Surgery Center, the First Affiliated Hospital of Xinjiang Medical University, No. 137, Liyushan Road, Xinshi District, Urumqi 830054, Xinjiang Uyghur Autonomous Region, China. dr.wenhao@163.com
Telephone: +86-991-4362844 Fax: +86-991-4362844
Received: March 30, 2015
Peer-review started: March 31, 2015
First decision: May 18, 2015
Revised: May 29, 2015
Accepted: July 18, 2015
Article in press: July 18, 2015
Published online: September 21, 2015
Processing time: 171 Days and 19 Hours
Abstract

AIM: To evaluate the reliability and accuracy of three-dimensional (3D) reconstruction for liver resection in patients with hepatic alveolar echinococcosis (HAE).

METHODS: One-hundred and six consecutive patients with HAE underwent hepatectomy at our hospital between May 2011 and January 2015. Fifty-nine patients underwent preoperative 3D reconstruction and “virtual” 3D liver resection before surgery (Group A). Another 47 patients used conventional imaging methods for preoperative assessment (Group B). Outcomes of hepatectomy were compared between the two groups.

RESULTS: There was no significant difference in preoperative data between the two groups. Compared with patients in Group B, those in Group A had a significantly shorter operation time (227.1 ± 51.4 vs 304.6 ± 88.1 min; P < 0.05), less intraoperative blood loss (308.1 ± 135.4 vs 458.1 ± 175.4 mL; P < 0.05), and lower requirement for intraoperative blood transfusion (186.4 ± 169.6 vs 289.4 ± 199.2 mL; P < 0.05). Estimated resection liver volumes in both groups had good correlation with actual graft weight (Group A: r = 0.978; Group B: r = 0.960). There was a significant higher serum level of albumin in Group A (26.3 ± 5.9 vs 22.6 ± 4.3 g/L, P < 0.05). Other postoperative laboratory parameters (serum levels of aminotransferase and bilirubin; prothrombin time) and duration of postoperative hospital stay were similar. Sixteen complications occurred in Group A and 19 in Group B. All patients were followed for 3-46 (mean, 17.3) mo. There was no recurrence of lesions in Group A, but two recurrences in Group B. There were three deaths: two from cerebrovascular accident, and one from car accident.

CONCLUSION: 3D reconstruction provides comprehensive and precise anatomical information for the liver. It also improves the chance of success and reduces the risk of hepatectomy in HAE.

Keywords: Liver resection; Hepatic alveolar echinococcosis; Computed tomography; Three-dimensional reconstruction; Surgical planning

Core tip: With the rapid development of digital medicine, three-dimensional (3D) reconstruction software has become a new tool in surgery, and it is a quantitative imaging analysis system that provides real-time interactive tools for presurgical evaluation and planning. We compared the clinical results of hepatectomy for hepatic alveolar echinococcosis based on 3D software with traditional assessment. We found that liver resection based on 3D reconstruction was more effective in the diagnosis and treatment of HAE than techniques without 3D reconstruction. Such 3D reconstruction software for preoperative evaluation and surgical planning could increase the chance of success of surgery and reduce operative risk.