| Objective: To analyze the clinical application value of mixed reality technology for tumor prosthesis replacement surgery in the precision treatment of bone tumors.Methods: A retrospective analysis of the clinical data of 25 patients with extremity bone tumors who underwent tumor-type prosthesis replacement surgery and met the selection criteria in our department from August 2018 to September 2020,including 16 males and 9 females,and their age 12-76(34.4±20.6)years old.21 cases of malignant tumors,including 14 cases of osteosarcoma,3 cases of malignant giant cell tumor of bone,1 case of Ewing sarcoma,1 case of chondrosarcoma,1 case of malignant fibrous histiocytoma and 1 case of bone metastasis;4 cases of benign tumor,both of giant cell tumor of bone;8 cases of tumor located in the proximal tibia,4 cases in the proximal humerus,and 13 cases in the distal femur.According to whether mixed reality technology was used for surgery,they were divided into 11 cases in the mixed reality group and 14 cases in the control group.The operation time,intraoperative blood loss,postoperative drainage volume,patient satisfaction,postoperative lower limb length difference and the length difference and MSTS(Musculoskeletal Tumor Society)score3 months after surgery were compared between the two groups.Results: All 25 patients successfully completed the operation,and the tumor tissue was completely removed without any vascular and nerve damage.All 25 patients were followed up regularly,and the follow-up time was 4-26(13.9±6.6)months.One patient with distal femoral osteosarcoma died after 9 months of pulmonary metastasis,and one patient with distal femoral osteosarcoma failed to follow the doctor’s instructions and train 2 weeks after surgery,resulting in active bleeding inside the incision and hemostasis in the second operation,and there was no recurrence.The operation time of the mixed reality group was 160-290(227.45±39.35)min,and the operation time of the control group was 185-310(239.57 ± 36.25)min.There was no significant difference between the two groups(p>0.05).The blood loss of the mixed reality group was 200-550(409.09±97.00)ml,and the intraoperative blood loss of the control group was 300-700(521.43 ± 139.66)ml.The difference between the two groups was statistically significant(p=0.033).The postoperative drainage volume of the mixed reality group was 377-1390(949.00 ± 288.62)ml,and the postoperative drainage volume of the control group was 547-1930(1257.79 ± 389.20)ml.The difference between the two groups was statistically significant(p=0.038).In the mixed reality group,7 people were very satisfied,2 people were satisfied,and 2 people were ordinary.In the control group,2 people were very satisfied,6 people were satisfied,and 6 people were ordinary.The difference between the two groups was statistically significant(p=0.025).There was no significant difference in the length of bilateral limbs after the operation between the two groups(p>0.05).The MSTS score of the mixed reality group was 70.0%-93.3%(81.42% ± 7.16%)at 3 months after the operation,and the MSTS score of the control group was 66.7%-86.7%(76.44%±6.59%),the difference between the two groups was statistically significant(p=0.041).Conclusion: The mixed reality group is better than the control group in terms of intraoperative blood loss,postoperative drainage,patient satisfaction,and MSTS scores3 months after surgery.There is no significant difference in terms of the operation time and the length of bilateral limbs after surgery.The mixed reality 3D holographic imaging model can facilitate physicians’ multi-angle observation and analysis,and facilitate physicians to formulate corresponding surgical plans.Through simulate surgical operations,physicians can fully understand the technical difficulties and operational details of the operation,thereby further optimizing the surgical plan,reducing surgical risks and intraoperative injury,and improve the success rate of surgery.Three-dimensional imaging can also enable better communication between doctors and patients,improve patient cooperation and compliance with treatment,improve patient satisfaction,and effectively avoid potential conflicts between doctors and patients. |
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