Background: 3D rendering (3DR) represents a promising approach to plan surgical strategies. The study aimed to compare the results of minimally invasive liver resections (MILS) in patients with 3DR versus conventional 2D CT-scan. Methods: We performed 118 3DR for various indications; the patients underwent a preoperative tri-phasic CT-scan and rendered with Synapse3D® Software. Fifty-six patients undergoing MILS with pre-operative 3DR were compared to a similar cohort of 127 patients undergoing conventional pre-operative 2D CT-scan using the propensity score matching (PSM) analysis. Results: The 3DR mandated pre-operative surgical plan variations in 33.9% cases, contraindicated surgery in 12.7%, providing a new surgical indication in 5.9% previously excluded cases. PSM identified 39 patients in both groups with comparable results in terms of conversion rates, blood loss, blood transfusions, parenchymal R1-margins, grade ≥3 Clavien-Dindo complications, 90-days mortality, and hospital stay respectively in 3DR and conventional 2D. Operative time was significantly increased in the 3DR group (402 vs. 347 min, p = 0.020). Vascular R1 resections were 25.6% vs 7.7% (p = 0.068), while the conversion rate was 0% vs 10.2% (p = 0.058), respectively, for 3DR group vs conventional 2D. Conclusion: 3DR may help in surgical planning increasing resectability rate while reducing conversion rates, allowing the precise identification of anatomical landmarks in minimally invasive parenchyma-preserving liver resections.

Role of preoperative 3D rendering for minimally invasive parenchyma sparing liver resections / Montalti, Roberto; Rompianesi, Gianluca; Cassese, Gianluca; Pegoraro, Francesca; Giglio, Mariano C.; De Simone, Giuseppe; Rashidian, Nikdokht; Venetucci, Pietro; Troisi, Roberto I.. - In: HPB. - ISSN 1477-2574. - (2023). [10.1016/j.hpb.2023.04.008]

Role of preoperative 3D rendering for minimally invasive parenchyma sparing liver resections

Roberto Montalti
Primo
Writing – Original Draft Preparation
;
Gianluca Rompianesi;Gianluca Cassese;Francesca Pegoraro;Mariano C. Giglio;Pietro Venetucci;
2023

Abstract

Background: 3D rendering (3DR) represents a promising approach to plan surgical strategies. The study aimed to compare the results of minimally invasive liver resections (MILS) in patients with 3DR versus conventional 2D CT-scan. Methods: We performed 118 3DR for various indications; the patients underwent a preoperative tri-phasic CT-scan and rendered with Synapse3D® Software. Fifty-six patients undergoing MILS with pre-operative 3DR were compared to a similar cohort of 127 patients undergoing conventional pre-operative 2D CT-scan using the propensity score matching (PSM) analysis. Results: The 3DR mandated pre-operative surgical plan variations in 33.9% cases, contraindicated surgery in 12.7%, providing a new surgical indication in 5.9% previously excluded cases. PSM identified 39 patients in both groups with comparable results in terms of conversion rates, blood loss, blood transfusions, parenchymal R1-margins, grade ≥3 Clavien-Dindo complications, 90-days mortality, and hospital stay respectively in 3DR and conventional 2D. Operative time was significantly increased in the 3DR group (402 vs. 347 min, p = 0.020). Vascular R1 resections were 25.6% vs 7.7% (p = 0.068), while the conversion rate was 0% vs 10.2% (p = 0.058), respectively, for 3DR group vs conventional 2D. Conclusion: 3DR may help in surgical planning increasing resectability rate while reducing conversion rates, allowing the precise identification of anatomical landmarks in minimally invasive parenchyma-preserving liver resections.
2023
HPB
Role of preoperative 3D rendering for minimally invasive parenchyma sparing liver resections / Montalti, Roberto; Rompianesi, Gianluca; Cassese, Gianluca; Pegoraro, Francesca; Giglio, Mariano C.; De Simone, Giuseppe; Rashidian, Nikdokht; Venetucci, Pietro; Troisi, Roberto I.. - In: HPB. - ISSN 1477-2574. - (2023). [10.1016/j.hpb.2023.04.008]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/923490
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