术中超声联合CT三维重建在腹腔镜特殊肝段血管瘤剥除术中的应用效果OA

Objective To investigate the application effect of intraoperative ultrasound(IOUS)combined with CT three-dimensional(3D)reconstruction technology in laparoscopic enucleation of hemangiomas in specific liver segments(segmentsⅠ,Ⅳ a,Ⅶ and Ⅷ).Methods A single-center retrospective cohort study was conducted to analyze the clinical data of 44 patients who underwent laparoscopic hepatic hemangioma enucleation at the Affiliated Suzhou Hospital of Nanjing Medical University from January 2020 to August 2025.The patients were divided into an observation group(21 cases)and a control group(23 cases)based on whether IOUS and CT 3D reconstruction were applied.The following parameters were compared between the two groups through inverse probability weighting(IPTW)to balance baseline characteristics:operation time,hepatic pedicle clamping time,intraoperative blood loss,intraoperative blood transfusion rate,conversion to open surgery rate,postoperative complication rate,and postoperative time of hospital stay.Results After IPTW,compared with the control group,the observation group had significantly shorter operative time[150.0(112.6,180.0)min vs 168.6(141.6,203.2)min,Z=-2.106,P=0.041]and hepatic pedicle clamping time[29.9(27.9,32.0)min vs 40.5(29.6,48.0)min,Z=-2.329,P=0.025],as well as significantly less intraoperative blood loss[150.0(100.0,190.0)mL vs 217.9(189.9,300.0)mL,Z=-4.858,P<0.001].No significant difference was observed between the two groups in terms of intraoperative blood transfusion rate,conversion to open surgery rate,overall postoperative complication rate,or postoperative time of hospital stay(P>0.05).Conclusion Intraoperative ultrasound combined with CT 3D reconstruction technology facilitates precise laparoscopic enucleation of hemangiomas in specific liver segments.It can effectively reduce intraoperative bleeding and shorten operative time and hepatic pedicle clamping time,thereby optimizing the surgical procedure.