Perioperative Nursing Of Computer - Assisted Pediatric Precision Liver Tumor Resection

Objective To discuss the perioperative nursing method on children with precise liver resection under the guidance of computer assisted surgery system.Methods There were12children whose liver tumors were giant and involved hepatic portal vein in our hospital from January2012to January2014. They were treated with surgery. Psychological nursing and preoperative preparation had been accomplished before operation. Enhanced CT scanning and3d reconstruction had given to the children and the CT data was input to the computer assisted surgery system, then generated virtual three-dimensional image. Doctors and nurses use computer and the virtual3d image to explain the diseases to the parents of children, demonstrate the operation, to explain the surgery procedure, operation risk and possible complications after surgery. Doctors simulate surgery and formulate the most effective operation planning before surgery, excise liver tumors accurately under the guidance of computer assisted surgery system. Nursing cooperation was done well during operation, Nutrition support, the tube care, diet instruction,control of pain and the complications were strengthened after operation.Results Accurate liver resection was accomplished on the12children under the computer assisted surgery system. All of the cases, there were4cases with right liver resection,1case with right hepatic lobectomy,3cases with left half liver resection,3cases with right three lobe resection,1case with liver caudate lobe resection. The hemorrhage volume was2-150ml, its mean was32ml. The operation time was60-190min, its mean was119min. There were no cases with serious postoperative complications, such as serious hepatic function failure, severe abdominal bleeding, bile leakage and so on. There was no nursing complications and adverse events. Families of children cooperated with the treatment actively,and were satisfied with the treatment and nursing. Children with liver tumor were ultimately recovered and discharged after staying in hospital for8to14d, mean11.5d.Conclusion Computer assisted surgery system not only increases the safety of resection of liver tumors, but also makes the large, unresectable liver tumors located in the porta of liver resected, which was previously known as couldn’t. The health education to the children’s parents with the three-dimensional images can relieve their anxiety, enhance the trust of the parents to doctors and nurses. Well preparation before operation, effective coordination during operation and intensive care after operation can improve the safety of precise hepatectomy, can prevent and reduce the incidence of postoperative complications, can provide better chance for the pediatric patients to survive the perioperation and get well when be discharged.