Value of Computer Assisted Radiology and Surgery Solutions System in Surgical Planning for Precise Hepatectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 HOUJian-cun ,  ZHANGYa-min , WANGLian-jiang , SHIRui , LIYang , WUDi , CUIZi-lin , SHENZhong-yang

Department Hepatobiliary Surgery, Organ Transplantation Center, Tianjin First Central Hospital, Tianjin 300192, China;

Corresponding?author：

ZHANGYa-min, Email: zhangyamin@medmail.com.cn

Keywords：

Liver; Precise hepatectomy; Computer assisted radiology and surgery solutions system; Three dimensional reconstruction

DOI：

10.7507/1007-9424.20140033

Video：

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Objective To investigate the value of computer assisted radiology and surgery solutions system (IQQA-Liver) in surgical planning for precise hepatectomy. Methods The clinical data of 95 cases performed precise hepatec-tomy from January 1, 2012 to June 30, 2013 in our hospital were retrospectively analyzed, and the computer assisted radiology and surgery solutions system was used for three dimensional quantitative analysis, volume measurement and designing for liver resection in all the cases before operation. Results The intuitive and clear three dimensional images of all the 95 cases were obtained by using the computer assisted radiology and surgery solutions system, which could show the precise anatomical relationship of the liver, tumor, and main hepatic vascular.The three dimensional images could be observed at any angle and rotated freely, and could show the involved and needed to be resected vascular away from the tumor margin for 2 mm, 5 mm, 10 mm, and 20 mm and the liver volume dominated by this vascular.Of all the 95 cases, the total liver volume was (1 776.4±998.5) cm³, the proposed removed liver volume was (1 026.2±811.5) cm³, the functional residual liver volume was (795.3±522.6) cm³.The ratio of functional residual liver volume to the standard total liver volume was (58.2±25.1)%, which the ratio of patients without cirrhosis was > 30% and with cirrhosis was > 40%.All the 95 cases were implemented precise operation.The operation plan was designed based on a combination of factors such as the amount of functional residual liver volume and function.The surgery programs were changed for 13 cases, in which 9 cases were narrowed the scope of resection and 4 cases were expanded the scope of resection.No patients died perioperation. Conclusion By using the computer assisted radiology and surgery solutions system (IQQA-Liver), we could precisely locate liver tumor, calculate the functional residual liver volume, identify the relationship between tumor and adjacent vascular, and ultimately help to design the optimal surgical plan.

Citation： HOUJian-cun, ZHANGYa-min, WANGLian-jiang, SHIRui, LIYang, WUDi, CUIZi-lin, SHENZhong-yang. Value of Computer Assisted Radiology and Surgery Solutions System in Surgical Planning for Precise Hepatectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(2): 142-145. doi: 10.7507/1007-9424.20140033 Copy

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2.	Uchida K, Taniguchi M, Shimamura T, et al.Three-dimensional computed tomography scan analysis of hepatic vasculatures in the donor liver for living donor liver transplantation[J].Liver Transpl, 2010, 16(9):1062-1068.
3.	Fujimoto J, Yamanaka J.Liver resection and transplantation using a novel 3D hepatectomy simulation system[J].Adv Med Sci, 2006, 51:7-14.
4.	Wei L, Zhu ZJ, LüY, et al.Application of computer-assisted three-dimensional quantitative assessment and a surgical planning tool for living donor liver transplantation[J].Chin Med J (Engl), 2013, 126(7):1288-1291.
5.	Sharma R, Gibbs JF.Recent advances in the management of primary hepatic tumors refinement of surgical techniques and effect on outcome[J].J Surg Oncol, 2010, 101(8):745-754.
6.	LamadéW, Glombitza G, Fischer L, et al.The impact of 3-dime-nsional reconstructions on operation planning in liver surgery[J].Arch Surg, 2000, 135(11):1256-1261.
7.	Satou S, Sugawara Y, Tamura S, et al.Three-dimensional computed tomography for planning donor hepatectomy[J].Transplant Proc, 2007, 39(1):145-149.
8.	楊世忠, 張文智, 蔡守旺, 等.計算機輔助手術規劃系統在精準肝切除中的應用價值[J].中華消化外科雜志, 2010, 9(1):31-34.
9.	Cicinnati VR, MalagóM, Broering DC, et al.Drainage patterns of right and accessory hepatic veins:anatomical-functional classi-fication derived from 3-dimensional CT reconstructions[J].Hepa-togastroenterology, 2011, 58:110-111.
10.	Yamanaka J, Saito S, Iimuro Y, et al.The impact of 3-D virtual hepatectomy simulation in living-donor liver transplantation[J].J Hepatobiliary Pancreat Surg, 2006, 13(5):363-369.
11.	Yu KC, Ritman EL, Higgins WE.System for the analysis and visualization of large 3D anatomical trees[J].2007, 37(12):1802-1820.

1. Radtke A, Sotiropoulos GC, Molmenti EP, et al.Computer-assisted surgery planning for complex liver resections:when is it helpful? A single-center experience over an 8-year period[J].Ann Surg, 2010, 252(5):876-883.
2. Uchida K, Taniguchi M, Shimamura T, et al.Three-dimensional computed tomography scan analysis of hepatic vasculatures in the donor liver for living donor liver transplantation[J].Liver Transpl, 2010, 16(9):1062-1068.
3. Fujimoto J, Yamanaka J.Liver resection and transplantation using a novel 3D hepatectomy simulation system[J].Adv Med Sci, 2006, 51:7-14.
4. Wei L, Zhu ZJ, LüY, et al.Application of computer-assisted three-dimensional quantitative assessment and a surgical planning tool for living donor liver transplantation[J].Chin Med J (Engl), 2013, 126(7):1288-1291.
5. Sharma R, Gibbs JF.Recent advances in the management of primary hepatic tumors refinement of surgical techniques and effect on outcome[J].J Surg Oncol, 2010, 101(8):745-754.
6. LamadéW, Glombitza G, Fischer L, et al.The impact of 3-dime-nsional reconstructions on operation planning in liver surgery[J].Arch Surg, 2000, 135(11):1256-1261.
7. Satou S, Sugawara Y, Tamura S, et al.Three-dimensional computed tomography for planning donor hepatectomy[J].Transplant Proc, 2007, 39(1):145-149.
8. 楊世忠, 張文智, 蔡守旺, 等.計算機輔助手術規劃系統在精準肝切除中的應用價值[J].中華消化外科雜志, 2010, 9(1):31-34.
9. Cicinnati VR, MalagóM, Broering DC, et al.Drainage patterns of right and accessory hepatic veins:anatomical-functional classi-fication derived from 3-dimensional CT reconstructions[J].Hepa-togastroenterology, 2011, 58:110-111.
10. Yamanaka J, Saito S, Iimuro Y, et al.The impact of 3-D virtual hepatectomy simulation in living-donor liver transplantation[J].J Hepatobiliary Pancreat Surg, 2006, 13(5):363-369.
11. Yu KC, Ritman EL, Higgins WE.System for the analysis and visualization of large 3D anatomical trees[J].2007, 37(12):1802-1820.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Value of Computer Assisted Radiology and Surgery Solutions System in Surgical Planning for Precise Hepatectomy

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