| Objective: To explore the application value of 3D printing in the removal of pulmonary nodules in thoracic surgery.Methods:(1)Animal experiment: 20 New Zealand white rabbit animal experiments,all experimental animals under CT guided puncture into foreign body(FUYO Japanese company,material: pp)in lung nodules,foreign material density,and size of nodules are through strict correction and measurement.CT images were imported into Mimics18.0 software,and all the experimental animals were examined and positioned using CT and 3D printing technology respectively.Then,thoracoscopic surgery was performed by the operator,which was a preliminary experiment.(2)Clinical trials: select from April 15,2016 to 2016 March 15 day to our hospital to accept the surgical treatment of 60 patients with surrounding pulmonary nodules,were randomly divided into CT and 3D printing group,CT group use the computer scanning imaging,3D printing group will be printed in patients with pulmonary nodules structure,two sets of parallel vats resection,compared two groups of patients: Performer using CT slices and 3D print model to patients condition,in the replacement patient before and after the two times to answer questions related to the operation,to evaluate its disease related knowledge,using the quasi 3D model for patients with a satisfaction survey and primary qualified doctors satisfaction investigation;Intraoperative blood loss,operative time and number of lymph node resection were observed.Postoperative quality of life in both groups.Results:(1)Results of animal experiments: the results of animal experiments showed thatthe 3D printing model of pulmonary nodules was all consistent with the CT reconstruction and positioning,accurate positioning,complete surgical resection of pulmonary nodules and R0 cutting edge.(2)Results of clinical trials:(1)The cognition degree of 30 patients to pulmonary physiological function,lung anatomy and surgical plan after the treatment with 3D model was significantly higher than before the treatment(P<0.05).(2)Preoperative patients of all features,operation program and an understanding of the risk of complications by performer communicate in patients with CT data and 3D printing model,3D printing group of patients understanding of disease,surgery and preoperative complications to understand group were significantly superior to CT(9.4vs7.8 vs7.1 points,9.1 points,9.71 points vs5.8),statistically significant difference(P< 0.05).(3)Patients in the 3D printing group were significantly better than those in the CT group(29.5min vs45.5min,9.2min vs19.8min,9.2min vs5.1 min)in terms of preoperative conversation,duration and satisfaction of operation plan determination,and the difference was statistically significant(P<0.05).(4)3D printing group of patients with intraoperative blood loss,operating time were significantly superior to CT group(40 ml vs53 mL,48 min vs80min),statistically significant difference(P <0.05),but the removal of lymph node number was not significant difference between the two groups(P > 0.05).(5)The coincidence rate between the location of nodule and the location of 3D model was as high as 98.3%,the nutritional vascular coincidence rate of nodule reached 95.0%,and the bronchi compliance rate was 96.6%.(6)The understanding and overall satisfaction of pulmonary nodules were improved(6.2min before surgery vs.9.7min after surgery)by 6 junior doctors.(7)The self-care ability,activity ability and cognitive ability of patients in the 3D group were significantly higher than those in the CT group(P<0.05),while the difference in mental state and sleep quality score was not significant(P>0.05).Conclusion: 3D technology can build intuitive physical models.This technique can improve the accuracy of lesion location,which is beneficial for surgeons to choose the best surgical approach and improve the success rate.The physical model can improve the communication with patients and their families and enhance the understanding and trust of the medical process. |
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