Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2022; 14(1): 36-45
Published online Jan 27, 2022. doi: 10.4240/wjgs.v14.i1.36
Application value of mixed reality in hepatectomy for hepatocellular carcinoma
Liu-Yang Zhu, Jian-Cun Hou, Long Yang, Zi-Rong Liu, Wen Tong, Yi Bai, Ya-Min Zhang
Liu-Yang Zhu, Wen Tong, First Central Clinical College, Tianjin Medical University, Tianjin 300070, China
Jian-Cun Hou, Long Yang, Zi-Rong Liu, Yi Bai, Ya-Min Zhang, Department of Hepatobiliary Surgery, Tianjin First Central Hospital, Tianjin 300192, China
Author contributions: Zhu LY, Hou JC and Zhang YM designed the research; Zhu LY, Liu ZR, Tong W and Bai Y collected and analyzed the data; Zhu LY and Yang L wrote the paper; Hou JC and Zhang YM revised the paper.
Supported by Science and Technology Planning Projects of Tianjin, No. 19ZXDBSY00010; and Science and Technology Project of Tianjin Health Commission, No. ZC20174.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Tianjin first Central Hospital.
Informed consent statement: Patients were not required to give informed consent for the study because the clinical data were obtained retrospectively after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Min Zhang, MD, Chief Doctor, Department of Hepatobiliary Surgery, Tianjin First Central Hospital, No. 24 Fukang road, Nankai District, Tianjin 300192, China. 13802122219@163.com
Received: October 4, 2021
Peer-review started: October 4, 2021
First decision: November 18, 2021
Revised: November 29, 2021
Accepted: December 25, 2021
Article in press: December 25, 2021
Published online: January 27, 2022
Abstract
BACKGROUND

As a new digital holographic imaging technology, mixed reality (MR) technology has unique advantages in determining the liver anatomy and location of tumor lesions. With the popularization of 5G communication technology, MR shows great potential in preoperative planning and intraoperative navigation, making hepatectomy more accurate and safer.

AIM

To evaluate the application value of MR technology in hepatectomy for hepatocellular carcinoma (HCC).

METHODS

The clinical data of 95 patients who underwent open hepatectomy surgery for HCC between June 2018 and October 2020 at our hospital were analyzed retrospectively. We selected 95 patients with HCC according to the inclusion criteria and exclusion criteria. In 38 patients, hepatectomy was assisted by MR (Group A), and an additional 57 patients underwent traditional hepatectomy without MR (Group B). The perioperative outcomes of the two groups were collected and compared to evaluate the application value of MR in hepatectomy for patients with HCC.

RESULTS

We summarized the technical process of MR-assisted hepatectomy in the treatment of HCC. Compared to traditional hepatectomy in Group B, MR-assisted hepatectomy in Group A yielded a shorter operation time (202.86 ± 46.02 min vs 229.52 ± 57.13 min, P = 0.003), less volume of bleeding (329.29 ± 97.31 mL vs 398.23 ± 159.61 mL, P = 0.028), and shorter obstructive time of the portal vein (17.71 ± 4.16 min vs 21.58 ± 5.24 min, P = 0.019). Group A had lower alanine aminotransferas and higher albumin values on the third day after the operation (119.74 ± 29.08 U/L vs 135.53 ± 36.68 U/L, P = 0.029 and 33.60 ± 3.21 g/L vs 31.80 ± 3.51 g/L, P = 0.014, respectively). The total postoperative complications and hospitalization days in Group A were significantly less than those in Group B [14 (37.84%) vs 35 (60.34%), P = 0.032 and 12.05 ± 4.04 d vs 13.78 ± 4.13 d, P = 0.049, respectively].

CONCLUSION

MR has some application value in three-dimensional visualization of the liver, surgical planning, and intraoperative navigation during hepatectomy, and it significantly improves the perioperative outcomes of hepatectomy for HCC.

Keywords: Mixed reality, Hepatectomy, Hepatocellular carcinoma, Three-dimensional reconstruction, Surgical planning, Intraoperative navigation

Core Tip: Mixed reality (MR) is a new digital holographic imaging technology that enables real-world and virtual three-dimensional images to be displayed and interacted in the same visual space. MR has some application value in three-dimensional visualization of the liver, surgical planning, and intraoperative navigation during hepatectomy. We performed a retrospective study to evaluate the application value of MR technology in hepatectomy for hepatocellular carcinoma (HCC). MR significantly improved the perioperative outcomes of hepatectomy for HCC compared to hepatectomy with traditional methods, demonstrating the potential value of clinical application.