Application Of Accurate Assessment Of 3D Visualization In Surgery Treatment Of Portal Hypertension

Objective1.Collect CT data of patients with portal hypertension and construct a three-dimensional diagnosis and treatment model of portal system using 3D visualization technology.2.According to the results of three-dimensional reconstruction,the severity of portal hypertension is determined,the vascular variation is understood,individualized plans are established,and the surgical approach is guided.3.To study the application value of 3D visualization technology in portal hypertension.MethodsThe data were collected from 97 patients who underwent Laparoscopic Splenectomy plus Pericardial Devascularization(LSPD)from January 2017 to January 2018.According to whether the patient used three-dimensional visualization technology to reconstruct the portal system before surgery,the patients were divided into reconstruction group and non-reconstruction group.The number of patients in the two groups was 41 and 56 respectively.The clinical data of the two groups were compared by retrospective analysis,including preoperative data,such as gender,age,etiology,Child-pugh classification,etc.;surgical related data,such as:operation time,intraoperative hemorrhage,postoperative hospital stay,postoperative complications,etc.;and follow-up data of postoperative patients.After collecting the two sets of data and performing statistical analysis,we used the mean value for the count data;for the measurement data,we used theχ~2 test or Fisher’s exact test to analyze the correlation between the two groups;for the grade data,we used Mann-Whitney U test.Statistical analysis was performed using a statistical analysis software package(SPSS 20.0),and a P value<0.05 was considered statistically significant.ResultsAll patients underwent successful surgery without perioperative death and were followed up for 12 months to 24 months.In the non-reconstruction group,one patient converted to laparotomy during operation,and 2 patients with upper gastrointestinal hemorrhage were followed up.All the patients in the reconstruction group underwent laparoscopic surgery,none of them were converted to open surgery.One case of postoperative follow-up showed re-blood.The mean time of surgery in the reconstruction group was shorter than that in the non-reconstruction group(129.12min vs 145.13min,P<0.05).The average tunnel establishment time in the reconstruction group was also lower than that in the non-reconstruction group(28.51min vs 33.34min,P<0.001),and intraoperative bleeding(146.83ml vs190.89ml,P<0.001)and postoperative hospital stay(7.05d vs 8.02d,P<0.05)in the reconstruction group were lower than those in the non-reconstructed group.There were no significant differences between the two groups in terms of short-term and long-term complications(P>0.05).Conclusion1.LSPD is a safe and effective surgical method for the treatment of portal hypertension.Laparoscopy has the advantages of small damage,less intraoperative bleeding,quick recovery,and short hospital stay.2.Three-dimensional reconstruction can clearly show the portal vein system and collateral circulation vessels,which is helpful for distinguishing vascular variability and clinical classification of varicose veins.3.Three-dimensional reconstruction technology can effectively guide surgical operation and surgical approach,which can effectively reduce patient trauma,reduce intraoperative bleeding and unnecessary damage,and accelerate patient recovery.