The Effect of Three-Dimensional Preoperative Simulation on Liver Surgery

• Published in: World journal of surgery Vol. 41; no. 7; pp. 1840 - 1847
• Main Authors: Nakayama, Ken, Oshiro, Yukio, Miyamoto, Ryoichi, Kohno, Keisuke, Fukunaga, Kiyoshi, Ohkohchi, Nobuhiro
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-07-2017; Springer Nature B.V
• Subjects: Abdominal Surgery; Adolescent; Adult; Aged; Aged, 80 and over; Aspartate transaminase; Blood; Cardiac Surgery; Complications; Correlation; Female; General Surgery; Hepatectomy; Hepatectomy - methods; Humans; Imaging, Three-Dimensional; Liver; Liver - diagnostic imaging; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - surgery; Liver Volume; Male; Medicine; Medicine & Public Health; Middle Aged; Mortality; Operative Time; Original Scientific Report; Patients; Portal Vein Embolization; Postoperative Liver Failure; Remnant Liver Volume; Repeated Hepatectomy; Retrospective Studies; Simulation; Surgery; Thoracic Surgery; Tomography, X-Ray Computed; Transaminase; Vascular Surgery; Young Adult; Remnant Liver Volume; Postoperative Liver Failure; Liver Volume; Repeated Hepatectomy; Portal Vein Embolization
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-017-3933-7

Background
In the past decade, three-dimensional (3D) simulation has been commonly used for liver surgery. However, few studies have analyzed the usefulness of this 3D simulation. The aim of this study was to evaluate the effect of 3D simulation on the outcome of liver surgery.
Methods
We retrospectively analyzed 240 consecutive patients who underwent liver resection. The patients were divided into two groups: those who received 3D preoperative simulation (“3D group”,
n
 = 120) and those who did not undergo 3D preoperative simulation (“without 3D group”,
n
 = 120). The perioperative outcomes, including operation time, blood loss, maximum aspartate transaminase level, length of postoperative stay, postoperative complications and postoperative mortality, were compared between the two groups. The predicted resected liver volume was compared with the actual resected volume.
Results
The median operation time for the 3D group was 36 min shorter than that for the without 3D group (
P
 = 0.048). There were no significant differences in other outcomes between the two groups. A subgroup analysis revealed that the operation time of repeated hepatectomy and segmentectomy for the 3D group was shorter than that for the without 3D group (
P
 = 0.03). There was a strong correlation between the predicted liver volume and the actual resected liver weight (
r
 = 0.80,
P
 < 0.001).
Conclusion
These findings demonstrate that 3D preoperative simulation may reduce the operation time, particularly for repeated hepatectomy and segmentectomy.