The Clinical Application Of 3D Printing In Bone Tumor Surgery

Section 1 The clinical application of 3D printing technology in bone tumor surgeryObjective: to analyze the application and significance of 3D printing technology in 3D model printing of bone tumor surgery,production of surgical guide plate,preoperative surgical simulation and planning,and intraoperative guide plate.Methods: from November2016 to November 2018,patients receiving surgical treatment in our center who were assisted by 3D printing technology were included in this study.There were 22 males and15 females.The average age ranged from 6 to 67 years old,34.7 years old.Preoperative diagnosis was clear: 17 cases of pelvic area(5 cases of osteosarcoma,5 cases of chondrosarcoma,3 cases of metastatic cancer,2 cases of giant cell tumor of bone,1 case of ewing's sarcoma,1 case of hydatid);There were 12 cases of extremities(9 cases of osteosarcoma,1 case of giant cell tumor of bone,2 cases of osteochondroma).There were5 cases in the neck(1 case of extra-osseous osteosarcoma,3 cases of metastatic carcinoma and 1 case of synovial sarcoma).Three cases of shoulder blade(chondrosarcoma 1,exophytic chondroma 1,metastatic carcinoma 1).To explore the clinical application of 3D printing technology and analyze the operative time,blood loss and postoperative functional score.Results: all the 37 patients successfully applied the 3D printing technology,and the operation time was 2.5 ~ 7.5 h,with an average of 4.9 h.Intraoperative blood loss ranged from 200 to 5000 mL,with an average of 1480 mL.All 37 patients were followed up for 11-48 months,with an average of 15.4 months.Enneking score was used for limb function evaluation after limb tumor surgery.The scores of 12 patients were 17 ~ 26,with an average of 21 points.Excellent 5 cases,good 5 cases and medium 2 cases were obtained.Conclusion: the application of 3D printing technology in the surgery of bone tumors can more directly display the tumor information and achieve a more comprehensive preoperative evaluation.By means of preoperative operation simulation,the intraoperative fault tolerance rate was improved and the difficulty of operation was reduced.It provides a new solution for the diagnosis and treatment of bone tumor patients.Section 2 Effect analysis of pelvic tumor resection assisted by 3D printed guide plateObjective: To analyze the application and significance of 3D printing in the surgical simulation and planning of pelvic malignant tumors before surgery,surgical resection and postoperative resection effect analysis.Methods:A retrospective analysis was made of 20 cases of primary pelvic malignant tumors,including 11 males and 9 females,with an average age of 39.1 years(14 ~60 years),admitted to xinjiang university of medical science and technology from January 2014 to January 2018.Osteosarcoma(7 cases),chondrosarcoma(12 cases),ewing's sarcoma(1 cases).Consult Enneking pelvis classification,involving 10 cases of pelvic ?area and ? area 6 cases,?area and ?area 6 cases,?area,and ? area 8 cases.According to whether or not to use the 3D printed osteotomy guide,10 cases were divided into the 3D printed guide group and 10 cases were divided into the conventional group.The operation time,blood loss,function score and linear distance deviation were compared between the two groups.Results:The operation of 20 patients was completed successfully and the whole excision was obtained.Operation time of the 3D printed guide plate group(4.4 ± 1.4)h was not statistically significant compared with that of the control group(4.5 ± 1.4)h(P =0.83).There was no significant difference in intraoperative blood loss(1980±1158)ml between the 3D printing guide plate group and the control group(2785±1784)ml(P =0.15).Postoperative MSTS score(20.4 + 0.98)in the 3D printing guide plate group showed no significant difference from that in the conventional group(20.2±1.29)(P =0.78).The mean linear difference(3.8±1.9)cm in the 3D printed guide plate group was statistically significant(P = 0.001)compared with that in the conventional group(8.7±1.0).Conclusion: The 3D printing group was no different from the non-3d printing group in terms of operation time,blood loss and function score,but the accuracy of surgical resection was better than the conventional group.