Application of three-dimensional visualization technique vs. two-dimensional imaging technique in hepatectomy: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Tongxin , AI Longlong , ZHANG Yujiang , ZHANG Yaojun ,  Ahetibieke

Department of General Surgery, the Second Affiliated Hospital, Xinjiang Medical University, Urumqi, 830001, P.R.China;

Corresponding?author：

Ahetibieke, Email: ahet050@sina.com

Keywords：

Three-dimensional visualization technique; Two-dimensional imaging technique; Hepatectomy; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.201803058

Video：

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ObjectivesTo systematically review the clinical efficacy of three-dimensional (3D) visualization vs. two-dimensional (2D) imaging technique in hepatectomy.MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect clinical trials which compared 3D visualization with conventional 2D imaging technique for hepatectomy from inception to September 2017. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies, and then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 studies involving 953 patients were included. The results of meta-analysis showed that: compared to 2D imaging technique, 3D visualization technique could improve R₀ resection rate (OR=2.91, 95%CI 1.31 to 6.43, P=0.009), had lower incidence of postoperative complication (OR=0.55, 95%CI 0.38 to 0.80, P=0.002), less amount of blood transfusion in operation (MD=–96.05, 95%CI –126.78 to –65.31, P<0.000 01), lower discrepancy range between the volume of the predicted liver resection and actual resection volume (MD=–94.38, 95%CI –185.46 to –3.30,P=0.04), shorter operation time (MD=–33.58, 95%CI –60.09 to –7.08, P=0.01), and lower intraoperative blood loss (MD=–79.70, 95%CI –139.86 to –19.53, P=0.009), the differences were statistically significant. There were no statistical differences between two groups in postoperative hospital stay time (MD=–0.75, 95%CI –2.45 to 0.95, P=0.39).ConclusionsThe current evidence shows that application of 3D visualization technique in hepatectomy can predict the liver resection volume more accurately, improve the R₀ resection rate, shorten operation time, decrease intraoperative blood transfusion volume and the amount of bleeding, and reduce the incidence of postoperative complications. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.

Citation： ZHANG Tongxin, AI Longlong, ZHANG Yujiang, ZHANG Yaojun, Ahetibieke. Application of three-dimensional visualization technique vs. two-dimensional imaging technique in hepatectomy: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2018, 18(8): 850-857. doi: 10.7507/1672-2531.201803058 Copy

1.	鄭宗英, 楊元華. 超聲引導細針穿刺抽吸組織學檢查對肝臟惡性腫瘤的診斷研究. 中華物理醫學與康復雜志, 1991, 13(4): 207-210.
2.	周儉, 黃成, 樊嘉. 肝移植相關技術在復雜肝臟腫瘤切除術中的應用. 中華肝臟外科手術學電子雜志, 2012, 1(3): 147-150.
3.	方馳華, 陶海粟. 影像學新技術在肝膽胰外科精準診斷與治療中的應用. 中華消化外科雜志, 2016, 15(1): 22-26.
4.	劉允怡, 張紹祥, 姜洪池, 等. 復雜性肝臟腫瘤三維可視化精準診治專家共識. 中國實用外科雜志, 2017, 37(1): 53-59.
5.	劉春. 22例外生性肝癌的診治分析. 長沙: 中南大學, 2009.
6.	肖林峰. 三維可視化重建技術在腹部外科術前評估的臨床應用研究. 廈門: 廈門大學, 2014.
7.	陶海粟. 三維可視化技術在中央型肝癌診治中的應用. 廣州: 南方醫科大學, 2016.
8.	舒曉亮, 康凱, 鐘靜霞, 等. 高支鏈氨基酸營養支持對肝臟手術患者肝功能保護作用的 Meta 分析. 中華肝臟病雜志, 2014, 22(1): 43-47.
9.	楊凝清. 信息時代醫學信息教育模式初探. 中華醫學圖書情報雜志, 2002, 11(6): 1-3.
10.	周為文, 葛龍, 徐俊峰, 等. 《中國循證醫學雜志》發表的干預類系統評價/Meta 分析報告質量評價. 中國循證醫學雜志, 2013, 13(4): 482-488.
11.	Zeng X, Zhang Y, Kwong JS, et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review. J Evid Based Med, 2015, 8(1): 2-10.
12.	Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Available at: http://:handbook.cochrane.org.
13.	李慧, 毛紹菊, 孫瑋璇, 等. 鎘與老年性癡呆相關性的 Meta 分析. 中國循證醫學雜志, 2015, 15(9): 1030-1034.
14.	張豆豆, 陳海鋒, 黃思慶, 等. 后顱窩減壓及硬膜成形術與單純后顱窩減壓術比較治療Ⅰ型 Chiari 畸形效果的 Meta 分析. 中國循證醫學雜志, 2012, 12(9): 1090-1097.
15.	Bégin A, Martel G, Lapointe R, et al. Accuracy of preoperative automatic measurement of the liver volume by CT-scan combined to a 3D virtual surgical planning software (3DVSP). Surg Endosc, 2014, 28(12): 3408-3412.
16.	Yamanaka J, Saito S, Fujimoto J. Impact of preoperative planning using virtual segmental volume try on liver resection for hepatocellular carcinoma. World J Surg, 2007, 31(6): 1251-1257.
17.	Pianka F, Baumhauer M, Stein D, et al. Liver tissue sparing resection using a novel planning tool. Langenbecks Arch Surg, 2011, 396(2): 201-208.
18.	Su L, Dong Q, Zhang H, et al. Clinical application of a three-dimensional imaging technique in infants and young children with complex liver tumors. Pediatr Surg Int, 2016, 32(4): 387-395.
19.	Fang CH, Tao HS, Yang J, et al. Impact of three-dimensional reconstruction technique in the operation planning of centrally located hepatocellular carcinoma. J Am Coll Surg, 2015, 220(1): 28-37.
20.	Okuda Y, Taura K, Seo S, et al. Usefulness of operative planning based on 3-dimensional CT cholangiography for biliary malignancies. Surgery, 2015, 158(5): 1261-1271.
21.	Fang CH, Liu J, Fan YF, et al. Outcomes of hepatectomy for hepatolithiasis based on 3-dimensional reconstruction technique. J Am Coll Surg, 2013, 217(2): 280-288.
22.	Yi-Biao, Tuerganaili, Jiang, et al. Application of 3D reconstruction for surgical treatment of hepatic alveolar echinococcosis. World J Gastroenterol, 2015, 21(35): 10200-10207.
23.	胡志剛, 黃拼搏, 周振宇, 等. 二維影像技術和三維可視化技術輔助 ALPPS 治療肝癌效果的初步探討. 中華外科雜志, 2016, 54(9): 686-691.
24.	方馳華, 陳青山, 方程, 等. 三維可視化技術輔助的肝切除術治療原發性肝癌的療效分析. 中華外科雜志, 2015, 53(8): 574-579.
25.	余璠, 魯正. 三維可視化技術在肝門部膽管癌術前評估中的應用. 中國腫瘤臨床, 2017,44(8): 390-394.
26.	胡志剛, 黃拼搏, 周振宇, 等. 醫學三維可視化技術在肝癌切除術中的應用現狀及發展趨勢. 中國實用外科雜志, 2016, 36(6): 699-701.
27.	陳華偉. 基于MRA數據的頸動脈三維可視化研究與實現. 武漢: 武漢理工大學, 2015.
28.	劉凱, 于紅, 劉士遠, 等. 圖像處理技術在醫學影像學教學中的意義. 臨床和實驗醫學雜志, 2010, 9(18): 1437-1437.
29.	董家鴻, 楊世忠, 段偉東, 等. 精準肝臟外科技術在復雜肝臟占位性病變切除中的應用.中華外科雜志, 2009, 47(21): 1610-1615.
30.	范應方, 項楠, 蔡偉, 等. 三維可視化技術在精準肝切除術前規劃中的應用. 中華肝臟外科手術學電子雜志, 2014, 3(5): 271-275.
31.	李建平, 楊軍. 精準肝切除研究進展. 中華肝膽外科雜志, 2011, 17(5): 434-436.

1. 鄭宗英, 楊元華. 超聲引導細針穿刺抽吸組織學檢查對肝臟惡性腫瘤的診斷研究. 中華物理醫學與康復雜志, 1991, 13(4): 207-210.
2. 周儉, 黃成, 樊嘉. 肝移植相關技術在復雜肝臟腫瘤切除術中的應用. 中華肝臟外科手術學電子雜志, 2012, 1(3): 147-150.
3. 方馳華, 陶海粟. 影像學新技術在肝膽胰外科精準診斷與治療中的應用. 中華消化外科雜志, 2016, 15(1): 22-26.
4. 劉允怡, 張紹祥, 姜洪池, 等. 復雜性肝臟腫瘤三維可視化精準診治專家共識. 中國實用外科雜志, 2017, 37(1): 53-59.
5. 劉春. 22例外生性肝癌的診治分析. 長沙: 中南大學, 2009.
6. 肖林峰. 三維可視化重建技術在腹部外科術前評估的臨床應用研究. 廈門: 廈門大學, 2014.
7. 陶海粟. 三維可視化技術在中央型肝癌診治中的應用. 廣州: 南方醫科大學, 2016.
8. 舒曉亮, 康凱, 鐘靜霞, 等. 高支鏈氨基酸營養支持對肝臟手術患者肝功能保護作用的 Meta 分析. 中華肝臟病雜志, 2014, 22(1): 43-47.
9. 楊凝清. 信息時代醫學信息教育模式初探. 中華醫學圖書情報雜志, 2002, 11(6): 1-3.
10. 周為文, 葛龍, 徐俊峰, 等. 《中國循證醫學雜志》發表的干預類系統評價/Meta 分析報告質量評價. 中國循證醫學雜志, 2013, 13(4): 482-488.
11. Zeng X, Zhang Y, Kwong JS, et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review. J Evid Based Med, 2015, 8(1): 2-10.
12. Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Available at: http://:handbook.cochrane.org.
13. 李慧, 毛紹菊, 孫瑋璇, 等. 鎘與老年性癡呆相關性的 Meta 分析. 中國循證醫學雜志, 2015, 15(9): 1030-1034.
14. 張豆豆, 陳海鋒, 黃思慶, 等. 后顱窩減壓及硬膜成形術與單純后顱窩減壓術比較治療Ⅰ型 Chiari 畸形效果的 Meta 分析. 中國循證醫學雜志, 2012, 12(9): 1090-1097.
15. Bégin A, Martel G, Lapointe R, et al. Accuracy of preoperative automatic measurement of the liver volume by CT-scan combined to a 3D virtual surgical planning software (3DVSP). Surg Endosc, 2014, 28(12): 3408-3412.
16. Yamanaka J, Saito S, Fujimoto J. Impact of preoperative planning using virtual segmental volume try on liver resection for hepatocellular carcinoma. World J Surg, 2007, 31(6): 1251-1257.
17. Pianka F, Baumhauer M, Stein D, et al. Liver tissue sparing resection using a novel planning tool. Langenbecks Arch Surg, 2011, 396(2): 201-208.
18. Su L, Dong Q, Zhang H, et al. Clinical application of a three-dimensional imaging technique in infants and young children with complex liver tumors. Pediatr Surg Int, 2016, 32(4): 387-395.
19. Fang CH, Tao HS, Yang J, et al. Impact of three-dimensional reconstruction technique in the operation planning of centrally located hepatocellular carcinoma. J Am Coll Surg, 2015, 220(1): 28-37.
20. Okuda Y, Taura K, Seo S, et al. Usefulness of operative planning based on 3-dimensional CT cholangiography for biliary malignancies. Surgery, 2015, 158(5): 1261-1271.
21. Fang CH, Liu J, Fan YF, et al. Outcomes of hepatectomy for hepatolithiasis based on 3-dimensional reconstruction technique. J Am Coll Surg, 2013, 217(2): 280-288.
22. Yi-Biao, Tuerganaili, Jiang, et al. Application of 3D reconstruction for surgical treatment of hepatic alveolar echinococcosis. World J Gastroenterol, 2015, 21(35): 10200-10207.
23. 胡志剛, 黃拼搏, 周振宇, 等. 二維影像技術和三維可視化技術輔助 ALPPS 治療肝癌效果的初步探討. 中華外科雜志, 2016, 54(9): 686-691.
24. 方馳華, 陳青山, 方程, 等. 三維可視化技術輔助的肝切除術治療原發性肝癌的療效分析. 中華外科雜志, 2015, 53(8): 574-579.
25. 余璠, 魯正. 三維可視化技術在肝門部膽管癌術前評估中的應用. 中國腫瘤臨床, 2017,44(8): 390-394.
26. 胡志剛, 黃拼搏, 周振宇, 等. 醫學三維可視化技術在肝癌切除術中的應用現狀及發展趨勢. 中國實用外科雜志, 2016, 36(6): 699-701.
27. 陳華偉. 基于MRA數據的頸動脈三維可視化研究與實現. 武漢: 武漢理工大學, 2015.
28. 劉凱, 于紅, 劉士遠, 等. 圖像處理技術在醫學影像學教學中的意義. 臨床和實驗醫學雜志, 2010, 9(18): 1437-1437.
29. 董家鴻, 楊世忠, 段偉東, 等. 精準肝臟外科技術在復雜肝臟占位性病變切除中的應用.中華外科雜志, 2009, 47(21): 1610-1615.
30. 范應方, 項楠, 蔡偉, 等. 三維可視化技術在精準肝切除術前規劃中的應用. 中華肝臟外科手術學電子雜志, 2014, 3(5): 271-275.
31. 李建平, 楊軍. 精準肝切除研究進展. 中華肝膽外科雜志, 2011, 17(5): 434-436.

Chinese Journal of Evidence-Based Medicine

Application of three-dimensional visualization technique vs. two-dimensional imaging technique in hepatectomy: a meta-analysis

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