Pre-operative planning

术前计划
  • 文章类型: Case Reports
    近几十年来,由于增强的临床概念和更大的成像工具支持了更好的诊断,子宫内膜异位症越来越普遍。对于这种复杂的病理生理状况,需要超越细胞水平的多学科护理策略,以使患者能够过上无病的生活。该案例研究的特征是一名年轻女性,她被诊断患有子宫内膜异位症,并对未来的生育能力感到担忧。这种情况最终导致了一系列事件,这些事件定义了所涉及疾病的复杂性和伴随的并发症,这些并发症得到了更好的检测,所以,通过成像相对简化了治疗,这有助于管理疾病及其问题。相关的并发症是公认的;然而,随着3D成像技术的应用,疾病,其程度,和相关的并发症可以通过有计划的方式进行管理。
    Endometriosis has been more common in recent decades as a result of improved diagnosis supported by enhanced clinical concepts and greater imaging tools. A multidisciplinary care strategy that extends beyond the cellular level is required for this complicated pathophysiological condition to enable patients to live disease-free lives. This case study features a young woman who was diagnosed with endometriosis and was anxious about future fertility. The condition eventually led to a series of events that defined the intricacy of the sickness involved and the accompanying complications that were better detected, and so, therapy was comparatively simplified by imaging, which helped manage the ailment and its issues. The related complications are well established; however, with the impending use of 3D imaging technology, the disease, its extent, and associated complications can be managed in a well-planned manner.
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  • 文章类型: Journal Article
    目的:翻修全髋关节置换术(rTHA)的主要挑战是骨丢失的治疗和术前计划。3D打印模型可以增强术前规划。该研究的目的是比较计划使用3D打印模型的Poprosky3型rTHA与使用常规成像技术(X射线和CT扫描)完成的手术中和围手术期结果和成本。
    方法:在2014年至2021年期间,72例Poprosky3型缺损患者接受了rTHA。52名患者接受了标准计划治疗,20名患者计划使用3D打印模型。手术时间,术中失血,输血单位数,术后住院天数,比较两组髋臼环的使用情况。还进行了成本比较。
    结果:3D打印组显示手术时间减少(101.8分钟(SD27.7)与146.1min(SD49.5),p<0.001)和总住院天数(9.3天(SD3.01)与12.3天(SD6.01),p=0.009)。手术费用明显低于对照组,调整后的差额为4183欧元(p=0.004)。输血总数和失血量以及髋臼环的数量没有显着差异。
    结论:3D打印模型的使用导致了有意义的成本节约。复杂RTHA的3D打印术前计划似乎可以有效减少手术时间,住院时间和总成本。
    The main challenges in revision total hip arthroplasty (rTHA) are the treatment of the bone loss and the pre-operative planning. 3D-printed models may enhance pre-operative planning. The aim of the study is to compare the intra- and peri-operative results and costs for Paprosky type 3 rTHAs planned with 3D-printed models to ones accomplished with the conventional imaging techniques (X-rays and CT scan).
    Seventy-two patients with Paprosky type 3 defect underwent rTHA between 2014 and 2021. Fifty-two patients were treated with standard planning and 20 were planned on 3D-printed models. Surgical time, intra-operative blood loss, number of transfused blood units, number of post-operative days of hospitalization, and use of acetabular rings were compared between the two groups. A costs comparison was also performed.
    The 3D-printed group showed reduced operative time (101.8 min (SD 27.7) vs. 146.1 min (SD 49.5), p < 0.001) and total days of hospitalization (9.3 days (SD 3.01) vs. 12.3 days (SD 6.01), p = 0.009). The cost of the procedures was significantly lower than the control group, with an adjusted difference of 4183 euros (p = 0.004). No significant differences were found for the number of total transfused blood units and blood loss and the number of acetabular rings.
    The use of 3D-printed models led to a meaningful cost saving. The 3D-printed pre-operative planning for complex rTHAs seems to be effective in reducing operating time, hospital stay and overall costs.
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  • 文章类型: Case Reports
    Cox-MazeIV程序(CMP-IV)对患有房颤的无坐位右位心患者的安全性和有效性尚待确定。在这里,我们介绍一例39岁男性患者,因进行性劳力性呼吸困难而入住我们心脏中心.病人被诊断为右位肌位反肌,重度二尖瓣反流,阵发性心房颤动.嵌入有指定消融线的三维(3D)心脏模型打印设备用于术前规划。二尖瓣成形术,CMP-IV,并进行了三尖瓣瓣环成形术。患者恢复顺利,在使用24小时Holter监测设备的12个月随访期间处于窦性心律。本文的案例是首次报道采用CMP-IV程序治疗患有复杂瓣膜成形术的坐位无右位心患者的案例之一。此外,3D打印技术使我们能够练习Cox-mazeIV程序,鉴于患者独特的心脏解剖结构。
    The safety and efficacy of the Cox-Maze IV procedure (CMP-IV) for situs inversus dextrocardia patients with atrial fibrillation is yet to be determined. Herein, we present the case of a 39-year-old male patient admitted to our cardiac center following progressive exertional dyspnea. The patient was diagnosed with situs inversus dextrocardia, severe mitral regurgitation, and paroxysmal atrial fibrillation. A three-dimensional (3D) heart model printing device embedded with designated ablation lines was used for pre-operative planning. Mitral valvuloplasty, CMP-IV, and tricuspid annuloplasty were performed. The patient had an uneventful recovery and was in sinus rhythm during a 12-month follow-up period using a 24-h Holter monitoring device. The case herein is one of the first to report on adopting the CMP-IV procedure for situs inversus dextrocardia patients with complex valvuloplasty operation. In addition, the 3D printing technique enabled us to practice the Cox-maze IV procedure, given the patient\'s unique cardiac anatomy.
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  • 文章类型: Case Reports
    患者专用指南用于矫正成人桡骨远端骨折的畸形愈合后遗症。它们允许径向关节盂取向的三维校正。然而,在这些适应症中,加长是很小的。在文献中从未报道过这种适应症的三维(3D)计划之后,远端桡骨上生理固定术矫正更为罕见,并且是针对患者的指导。
    我们报告了一例16岁的青少年,患有慢性腕部疼痛和尺骨阳性变异,创伤后桡骨外皮固定后遗症。半径比尺骨短11mm。通过延长半径来决定解剖重建。术前计划和针对患者的指导允许控制重要的径向延长,为了限制髂骨骨移植的发病率,精确地塑造移植物,尽管有重要的软组织张力,但仍保持正确的放射状关节盂取向。6个月时的临床和放射学结果显示疼痛完全消失,最佳客观和主观功能得分,尺骨远端方差(7mm)有所改善。这位少年没有限制或痛苦地重返运动。
    3Dplanning和术中针对患者的放射状上皮固定后遗症指南可实现对移植物和变形的3D精确测量,引导桡骨远端干骨干端切口的位置和方向,并限制了髂骨移植物收获的发病率。在这种情况下,它可以恢复手腕的全部功能,而不会留下疼痛。
    UNASSIGNED: Patient-specific guides are used in the correction of malunion sequelae in adult distal radius fractures. They allow a tridimensional correction of radial glenoid orientation. However, lengthening is small in those indications. Distal radius epiphysiodesis correction is much rarer and patient-specific guide after three-dimensional (3D) planning has never been reported for this indication in the literature.
    UNASSIGNED: We report the case of a 16-year-old teenager with a chronic painful wrist and an ulnar positive variance after a post-traumatic epiphysiodesis sequela of the radius. The radius was 11mm shorter than the ulna. An anatomic reconstruction was decided with a lengthening of the radius. Pre-operative planning and patient-specific guide allowed to control an important radial lengthening, to limit the morbidity of the iliac crest bone graft harvesting, to shape the graft precisely, and to maintain a correct radial glenoid orientation despite the important soft tissue tension. Clinical and radiological results at 6 months showed a complete disappearance of pain, optimal objective and subjective functional scores, and an improvement in the distal ulnar variance (7mm). The teenager went back to sport without limitation or pain.
    UNASSIGNED: 3Dplanning and intraoperative patient-specific guides in radial epiphysiodesis sequelae allow achieving 3D accurate measures of the graft and of the deformation, guiding the position and the orientation of the distal metaphysis cut of the radius, and limiting the morbidity of the iliac graft harvesting. In that case, it allowed restoring the full function of the wrist without remaining pain.
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