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The clinical application value of mixed‐reality‐assisted surgical navigation for laparoscopic nephrectomy

机译:腹腔镜肾切除术的混合现实辅助手术导航临床应用价值

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Purpose Laparoscopic nephrectomy (LN) has become the preferred method for renal cell carcinoma (RCC). Adequate preoperative assessment or intraoperative navigation is key to the successful implementation of LN. The aim of this study was to evaluate the clinical application value of mixed‐reality–assisted surgical navigation (MRASN) in LN. Patients and Methods A total of 100 patients with stage T1N0M0 renal tumors who underwent laparoscopic partial nephrectomy (LPN) or laparoscopic radical nephrectomy (LRN) were prospectively enrolled and divided into a mixed‐reality‐assisted laparoscopic nephrectomy (MRALN) group (n?=?50) and a non–mixed‐reality‐assisted laparoscopic nephrectomy (non‐MRALN) group (n?=?50). All patients underwent renal contrast‐enhanced CT scans. The CT DICOM data of all patients in the MRALN group were imported into the mixed‐reality (MR) postprocessing workstation and underwent holographic three‐dimensional visualization (V3D) modeling and MR displayed, respectively. We adopted the Likert scale to evaluate the clinical application value of MRASN. The consistency of evaluators was assessed using the Cohen kappa coefficient (k). Results No significant differences in patient demographic indicators between the MRALN group and the non‐MRALN group (P??.05). The subjective score of MRASN clinical application value in operative plan formulation, intraoperative navigation, remote consultation, teaching guidance, and doctor‐patient communication were higher in the MRASN group than in the non‐MRASN group (all P??.001). There were significantly more patients for whom LPN was successfully implemented in the MRALN group than in the non‐MRALN group (82% vs 46%, P??.001). The MRALN group had a shorter operative time (OT) and warm ischemia time (WIT) and less estimated blood loss (EBL) than the non‐MRALN group (all P??.001). Conclusion MRASN is helpful for operative plan formulation, intraoperative navigation, remote consultation, teaching guidance, and doctor‐patient communication. MRALN may effectively improve the successful implementation rate of LPN and reduce the OT, WIT, and EBL.
机译:目的腹腔镜肾切除术(LN)已成为肾细胞癌(RCC)的首选方法。适当的术前评估或术中导航是LN成功实施的关键。本研究的目的是评估混合现实辅助手术导航(MRASN)的临床应用价值。患者和方法共有100名患有腹腔镜部分肾切除术(LPN)或腹腔镜自由基肾切除术(LRN)的阶段T1N0M0肾肿瘤患者进行了前瞻性纳入并分为混合现实辅助的腹腔镜肾切除术(MRALN)组(N?= ?50)和非混合现实辅助的腹腔镜肾切除术(非MRALN)组(N?=?50)。所有患者都接受了肾比度增强的CT扫描。 MARN组中所有患者的CT DICOM数据进口到混合现实(MR)后处理工作站,并分别进行全息三维可视化(V3D)建模和MR显示。我们采用了李克特规模来评估MRASN的临床应用价值。使用Cohen Kappa系数(K)评估评估员的一致性。结果MARN组和非MRALN组之间的患者人口统计指标没有显着差异(P?> 05)。 MRASN临床应用价值的主观评分在手术计划制定中,术中导航,远程咨询,教学指导和篡改患者沟通在非MRASN组(所有P?<001)中更高。在MARAL组成功实施LPN的患者显着多于非MALN组(82%vs 46%,p?<001)。 MARAL组的操作时间(OT)和温暖的缺血时间(机智)和较少的血液损失(EBL)较少,而不是非MRALN组(所有P?<001)。结论MRASN有助于执行计划制定,术中导航,远程咨询,教学指导和医生沟通。 MARAL可以有效地提高LPN的成功实施率,并减少OT,机智和EBL。

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