混合现实技术辅助颅脑肿瘤外科手术初步探讨

A preliminary exploration of mixed reality technique in assisting craniocerebral tumor surgery

摘要:

目的 探究混合现实（MR）技术辅助颅脑肿瘤外科治疗过程中的价值。方法 收集2022年10月—2023年12月昆明医科大学第三附属医院神经外科诊治的颅脑肿瘤患者59例，根据是否采用MR技术辅助手术治疗分为MR技术组和常规手术组，MR技术组入组27例，术前均利用3D slicer将患者肿瘤可视化，结合MR技术术前定位肿瘤位置、设计皮肤切口、完善术前规划等；常规手术组入组32例，根据主刀医师手术经验进行手术治疗。收集两组病例术中出血、手术时长、骨瓣面积、术后住院时间，术后并发症发生率等指标。结果 MR技术组骨瓣面积20.92（15.29，28.54）cm²低于常规手术组的33.42（20.24，39.95）cm² （P=0.016）。MR技术组术后住院时间11（8，15）d低于常规手术组的16（13，18.75）d（P=0.000），MR技术组术后并发症的发生率11.1%低于常规手术组的40.6%（P=0.011）。结论 MR技术辅助颅脑肿瘤外科治疗可实现肿瘤可视化、辅助定位、制定手术方案、模拟手术等作用，在实现最大安全程度切除肿瘤方面有重要意义。

Abstract:

Objective To investigate the value of mixed reality （MR） technique in assisting the surgical treatment process of craniocerebral tumor.Methods A total of 59 patients with craniocerebral tumor who were diagnosed and treated in Department of Neurosurgery， The Third Affiliated Hospital of Kunming Medical University， from October 2022 to December 2023 were enrolled， and according to whether MR technique was used to assist surgical treatment， they were divided into MR technique group and conventional surgery group. For the 27 patients in the MR technique group， 3D slicer was used for tumor visualization， preoperative tumor localization， skin incision design， and preoperative planning； for the 32 patients in the conventional surgery group， surgical treatment was performed by the surgeon in charge based on his/her surgical experience. Related indicators were recorded for both groups， including intraoperative blood loss， time of operation， bone flap area， length of postoperative hospital stay， and the incidence rate of postoperative complications.Results The MR technique group had a significantly smaller median bone flap area than the conventional surgery group ［20.92 （15.29， 28.54） cm² vs 33.42 （20.24， 39.95） cm²， P = 0.016］. Compared with the conventional surgery group， the MR technique group had a significantly shorter length of postoperative hospital stay ［11 （8， 15） days vs 16 （13， 18.75） days， P = 0.000］ and a significantly lower incidence rate of postoperative complications （11.1% vs 40.6%， P = 0.011）.Conclusion MR technique for assisting the surgical treatment of craniocerebral tumor can help to achieve tumor visualization， assist in tumor localization， formulate the surgical plan， and perform surgical simulation， and it is of great significance in achieving the maximum degree of safety in tumor resection.