Preliminary Evaluate E On The Application Of 3D Printing Model In Surgical Treatment Of Renal Cell Carcinoma Combined With Inferior Vena Cava Tumor Thrombus

Objective: To evaluate the clinical application value of 3D printing model in surgical treatment of renal cancer with venous tumor thrombus.Methods: From May 2016 to July 2019,8 patients admitted to the First Affiliated Hospital of Guangxi Medical University who were clinically diagnosed with renal cancer combined with inferior vena cava thrombus and planned for surgery were included in the study.Of the 8 patients,7 were male,and 1was female.Imaging suggested the right renal tumor in all the 8 cases.tumor diameter of 5.0 to 13.2,average(7.93 ± 2.52)cm,length of inferior vena cava tumor thrombus 4 to 12 cm,average(7.14 ± 2.82)cm.Mayo Medical Center classification: type II thrombus in 7 cases,type Ⅲ thrombus in 1 case.All patients complete the CT scan + enhanced examination of the urinary system before operation,and extract the data of kidney tumor,inferior vena cava tumor thrombus and adjacent organs to create a specific 3D printed model with the actual size of the patient.The surgeon team designed the surgical plan and operation based on the 3D tumor model combined with the image data,and recorded the clinical data of the patient’s operation time,intraoperative blood loss,blood transfusion,postoperative hospital stay,complications,follow-up,etc.the competent physicians successively used CT images The information and3 D model are used to explain and communicate with the patient’s family.Before and after the 3D model presentation,please ask the patient’s family to fill out a questionnaire to evaluate the value of the 3D printed model in the doctor-patient communication.Results: 8 cases of 3D renal tumors were successfully printed.The model accurately represents the internal renal artery and vein,inferior vena cava,collection system,tumor,tumor thrombus and the adjacent anatomical structure.The model and intraoperative The actual anatomy is basically consistent.All 8patients successfully completed radical nephrectomy and inferior vena cava tumor thrombectomy without perioperative death case or serious surgical complications.The average surgery time was(304 ± 183.97)min,ranging from176～739 min.The average vena cava blocked time was(37.52 ± 29.53)min,ranging from 14 ～ 101 min.The average intraoperative blood loss was(2143.75 ± 1418.13)ml,ranging from 750～4500ml.The average red blood cells transfusion was(8.75 ± 3.95)U,the average plasma was(643.75 ± 473.16)ml,and the average postoperative hospital stay was(10.62 ± 2.61)days.After using the 3D renal tumor model to explain the condition,the patient’s family members’ understanding of the condition and complications of the surgical plan and the satisfaction of doctor-patient communication have improved significantly(p <0.05).Conclusion: 1.The 3D printed model is used to communicate with doctors and patients before surgery,which can effectively improve the patients and their families’ awareness of kidney tumor diseases,surgical methods and surgical risks,and is conducive to building a good doctor-patient relationship;2.3D renal tumors The model can visually display the three-dimensional anatomical structure of kidney tumors and kidneys,collections and systems,and the inferior vena cava and its adjacent tissues and organs.It can be used for preoperative surgical planning and intraoperative reference,the best surgical plan;Surgical treatment of kidney cancer with inferior vena cava tumor thrombi is difficult,high-risk,and has a poor prognosis.