Application Of 3D Printing Technology In Retroperitoneal Laparoscopic Partial Nephrectomy

BackgroundRenal cancer is a common malignant tumor of the urinary system.Its incidence is only secondary to bladder cancer in the late urinary system,accounting for 3% of adult malignant tumors.According to the maximum diameter of the tumor,the tumors confined to the kidney can be divided into T1 phase(maximum diameter ? 7 cm)and T2 phase(maximum diameter > 7 cm).At present,for T1 stage localized tumors,especially T1a(maximum diameter ? 4cm)stage tumors,partial nephrectomy is the preferred surgical method under feasible conditions,and it is no different from the classic radical nephrectomy in the past;For T2 stage localized tumors,partial nephrectomy is an optional surgical procedure.At present,partial nephrectomy is still a surgical procedure with considerable surgical difficulty in urology.In addition,laparoscopic surgery requires sophisticated laparoscopic techniques,which makes young doctors discouraged.3D printing technology has developed in the medical field for decades,and it has been applied to orthopedics,maxillofacial surgery,neurosurgery,cardiac surgery and other disciplines because of its high adherence to the basic medical principles of individualized treatment.For this reason,we actively explore its application value in partial nephrectomy.ObjectiveTo investigate the value of 3D printing technique in retroperitoneal laparoscopic partial nephrectomy(RLPN).METHODSTwenty patients with renal tumor who underwent laparoscopic partial nephrectomy underwent surgery from October 2017 to February 2018 in Zhengzhou University People's Hospital were randomly divided into observation groups according to the order of admission.And the control group,each group of 10 cases.CT imaging data of the observation group were extracted,and the patient's kidney model was made by 3D printing after processing with 3D imaging software.The surgeon used the 3D printed kidney model and the observation group for preoperative planning and exercise,and guided the operation.Traditional CT film is used for preoperative planning and guiding surgical procedures.Laparoscopic partial nephrectomy was performed in the two groups.The operation time,renal artery occlusion time,intraoperative blood loss,gastrointestinal recovery time,postoperative pathology Statistical analysis of the decline in renal glomerular filtration rate(GFR)was followed up for months.RESULTSThe operation time and renal artery occlusion time were(104.9±9.0)min and(23.4±2.7)min in the observation group,which were significantly shorter than those in the control group(118.0±10.9)min and(27.2±2.5)min.The difference was statistically significant(P<0.05).The decrease of renal GFR(10.07±4.91)ml/min was observed in the observation group at 3 months after operation,which was lower than that of the control group(15.95±5.06)ml/min.Statistical significance(P<0.05);there was no significant difference in the amount of intraoperative blood loss,postoperative gastrointestinal recovery time,and margin of positive margin in the observation group compared with the control group(P>0.05).ConclusionThe 3D printing model can reduce the time of surgery and renal artery occlusion and reduce renal damage.It is recommended.