Background: The application of medical image three-dimensional (3D) reconstruction technology can provide intuitive 3D image data support for accurate preoperative evaluation, surgical planning, and operation safety. However, there is still a lack of high-quality evidence to support whether 3D reconstruction technology is more advantageous in liver resection. Therefore, this study systematically evaluated the clinical effects of 3D reconstruction and two-dimensional (2D) image-assisted hepatectomy.
Methods: Databases were searched to collect published clinical studies on 3D reconstruction technology and 2D image-assisted liver resection. Data were extracted from the database construction to March 2022 and the risk of bias in the included studies was evaluated. Meta-analysis was performed using RevMan5.3 software.
Results: A total of 13 clinical studies were included, including 1616 patients, 795 in the 2D group and 819 in the 3D group. The meta-analysis showed that the incidence of postoperative complications was lower in the 3D group than in the 2D group (OR = 0.64, 95% CI = 0.49-0.83, P=0.001) and also reduced operation time (SMD = -0.51, 95% CI = -0.74∼-0.27, P < 0.0001), decreased intraoperative blood loss (SMD = -63.85, 95% CI = -98.66-29.04, P=0.0003), decreased incidence of postoperative liver failure (OR = 2.42, 95% CI = 0.99-5.95, P=0.05), decreased postoperative recurrence rate (OR = 0.29, 95% CI = 0.16-0.53, P < 0.0001), and increased postoperative survival rate (OR = 2.19, 95% CI = 1.49-3.23, P < 0.0001).
Conclusions: Current data suggest that 3D reconstruction-assisted hepatectomy can reduce intraoperative blood loss, postoperative complications, and recurrence, and improve postoperative survival. Therefore, the 3D reconstruction technique is worthy of application and promotion in assisted liver resection.
Copyright © 2022 Lei Zeng et al.