利用腹腔内三维打印技术提高移植物存活率,防止肝移植中的大尺寸综合征。

IF 1.1 Q4 GASTROENTEROLOGY & HEPATOLOGY Annals of hepato-biliary-pancreatic surgery Pub Date : 2025-02-28 Epub Date: 2024-09-26 DOI:10.14701/ahbps.24-153
Sunghae Park, Gyu-Seong Choi, Jong Man Kim, Sanghoon Lee, Jae-Won Joh, Jinsoo Rhu
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引用次数: 0

摘要

背景/目的:虽然大尺寸综合征在肝移植(LT)中并不常见,但它可能导致致命的结果。为了避免这种致命后果,我们在 2020 年 7 月至 2022 年 2 月期间制作了三维打印的腹腔内复制品,以便让体型较小的患者直观地了解移植物和患者腹部的大小:方法:通过1:5比例倾向得分匹配分析,比较在LT期间使用我们的三维模型的患者与未使用三维模型的LT患者的临床结果:结果:经过匹配,本研究共纳入了20名使用三维打印腹腔模型的患者和100名对照组患者。术后 30 天并发症(50.0% 对 64.0%,P = 0.356)和大尺寸综合征发生率(0% 对 7%,P = 0.599)无明显差异。3D打印组的总存活率与对照组相似(p = 0.665),但3D打印组的移植物存活率明显优于对照组(p = 0.034):结论:由于三维打印方案显示出较好的移植物存活率,且成本低、制作时间短,因此对于腹腔较小的患者来说,我们的三维打印方案是一种可行的选择,可预防LT术后的 "大尺寸综合征"。
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Improved graft survival by using three-dimensional printing of intra-abdominal cavity to prevent large-for-size syndrome in liver transplantation.

Backgrounds/aims: While large-for-size syndrome is uncommon in liver transplantation (LT), it can result in fatal outcome. To prevent such fatality, we manufactured 3D-printed intra-abdominal cavity replicas to provide intuitive understanding of the sizes of the graft and the patient's abdomen in patients with small body size between July 2020 and February 2022.

Methods: Clinical outcomes were compared between patients using our 3D model during LT, and patients who underwent LT without 3D model by using 1 : 5 ratio propensity score-matched analysis.

Results: After matching, a total of 20 patients using 3D-printed abdominal cavity model and 100 patients of the control group were included in this study. There were no significant differences in 30-day postoperative complication (50.0% vs. 64.0%, p = 0.356) and the incidence of large-for-size syndrome (0% vs. 7%, p = 0.599). Overall survival of the 3D-printed group was similar to that of the control group (p = 0.665), but graft survival was significantly superior in the 3D-printed group, compared to the control group (p = 0.034).

Conclusions: Since it showed better graft survival, as well as low cost and short production time, our 3D-printing protocol can be a feasible option for patients with small abdominal cavity to prevent large-for-size syndrome after LT.

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Neoadjuvant treatment for incidental gallbladder cancer: A systematic review. The role of artificial intelligence in pancreatic surgery: Current and future perspectives. Comment on: "Deep learning-based surgical phase recognition in laparoscopic cholecystectomy". ArtiSential® laparoscopic cholecystectomy versus singlefulcrum laparoscopic cholecystectomy: Which minimally invasive surgery is better? Improved graft survival by using three-dimensional printing of intra-abdominal cavity to prevent large-for-size syndrome in liver transplantation.
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