Discussion on three cases of retroperitoneal tumor involving great vessels by MDT mode under the aid of VR_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Tao , CHEN Kun ,  LI Wengang

Department of Hepatobiliary Surgery, School of Medicine of Xiamen University/Xiang’an Hospital of Xiamen University, Xiamen, Fujian 361102, P. R. China;

Corresponding author：

LI Wengang, Email: lwg11861@163.com

Keywords：

retroperitoneal tumor; multidisciplinary team; virtual reality; three-dimensional visualization; individualized treatment

DOI：

10.7507/1007-9424.202009060

Video：

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Objective To explore the application value of multidisciplinary collaborative team (MDT) model in retroperitoneal tumors involving large vessels.Methods Three cases of retroperitoneal tumors involving great vessels admitted to Xiang’an Hospital of Xiamen University in 2019 were retrospectively analyzed. With the support of 3D visual reconstruction and virtual reality (VR) technology, we performed MDT discussion and three cases received treatment of surgery, intervention, and targeted therapy.Results Case 1 was discussed by MDT and concluded that, based on CT examination, 3D reconstruction, and VR virtual image results, the tumor on the right side was determined to be completely resectable. The left tumor was judged to be unresectable, and the proposed treatment plan was right metastatic tumor resection + left metastatic tumor radiofrequency ablation. After surgery case 1 had been followed up for 6 months. The symptoms of diarrhea were significantly improved. CT reexamination showed that liver lesions and left retroperitoneal lesions were the same size and the condition was stable. After discussion by MDT, radiofrequency ablation around the tumor was proposed for case 2. This case was followed up for 3 months after surgery, and CT reexamination showed no new lesion in retroperitoneum. After MDT discussion, we concluded that arteriovenous fistula of case 3 had no indications for surgery, and proposed interventional combined with targeted therapy. After treatment, the tumor was found to be smaller after reexamination in 8 months than before treatment, and the efficacy was evaluated as partial remission. The follow-up was continued.Conclusion The future development trend of retroperitoneal tumor therapy involving great vessels is to evaluate each patient’s condition under the MDT mode by using 3D visual reconstruction and VR technology, and to formulate the individualized treatment plan of operation combined with other treatments.

Citation： LIU Tao, CHEN Kun, LI Wengang. Discussion on three cases of retroperitoneal tumor involving great vessels by MDT mode under the aid of VR. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(5): 649-656. doi: 10.7507/1007-9424.202009060 Copy

1.	邱法波, 张圣林, 蔡亦军, 等. 中国腹膜后肿瘤 10 年流行病学分析. 临床普外科电子杂志, 2013, 1(1): 31-36.
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10.	李菲菲. 基于 VR 技术的 3D 手术操作练习模拟器的设计与开发. 科技创新与应用, 2020, (16): 40-42.
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12.	Sugiyama T, Clapp T, Nelson J, et la. Immersive 3-Dimensional virtual reality modeling for case-specific presurgical discussions in cerebrovascular neurosurgery. Oper Neurosurg (Hagerstown), 2020, [Online ahead of print].
13.	Lungu AJ, Swinkels W, Claesen L, et al. A review on the applications of virtual reality, augmented reality and mixed reality in surgical simulation: an extension to different kinds of surgery. Expert Rev Med Devices, 2020, [Online ahead of print].
14.	Gronchi A, Strauss DC, Miceli R, et al. Variability in patterns of recurrence after resection of primary retroperitoneal sarcoma (RPS): a report on 1 007 patients from the Multi-Institutional Collaborative RPS Working Group. Ann Surg, 2016, 263(5): 1002-1009.
15.	MacNeill AJ, Miceli R, Strauss DC, et al. Post-relapse outcomes after primary extended resection of retroperitoneal sarcoma: A report from the Trans-Atlantic RPS Working Group. Cancer, 2017, 123(11): 1971-1978.
16.	Zaidi MY, Canter R, Cardona K. Post-operative surveillance in retroperitoneal soft tissue sarcoma: The importance of tumor histology in guiding strategy. J Surg Oncol, 2018, 117(1): 99-104.
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19.	李红丽, 郭占涛. 虚拟现实技术的应用及其不足. 信息通信, 2018, (12): 255-257.
20.	郭娜, 王田苗, 胡磊, 等. ACL 重建手术增强现实导航系统的人机交互技术. 计算机工程与应用, 2020, 56(21): 224-230.
21.	李宁, 曹志强. 增强现实、混合现实在泌尿外科导航手术中的应用. 中华腔镜泌尿外科杂志 (电子版), 2020, 14(4): 241-245.
22.	Bremjit PJ, Jones RL, Chai X, et al. A contemporary large single-institution evaluation of resected retroperitoneal sarcoma. Ann Surg Oncol, 2014, 21(7): 2150-2158.
23.	von Mehren M, Randall RL, Benjamin RS, et al. Soft Tissue Sarcoma, Version 2. 2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 2018, 16(5): 536-563.
24.	赵纪春, 陈熹阳. 累及大血管的腹膜后肿瘤的手术治疗. 中国普外基础与临床杂志, 2016, 23(3): 260-262.
25.	中华医学会外科学分会外科手术学学组, 中国抗癌协会肉瘤专业委员会, 中国医疗保健国际交流促进会软组织肿瘤分会, 等. 原发性腹膜后软组织肉瘤诊治中国专家共识 (2019 版). 中国实用外科杂志, 2019, 39(6): 526-532.

1. 邱法波, 张圣林, 蔡亦军, 等. 中国腹膜后肿瘤 10 年流行病学分析. 临床普外科电子杂志, 2013, 1(1): 31-36.
2. 查立超, 李修霞, 周斌, 等. 原发性腹膜后肉瘤预后研究进展. 腹部外科, 2020, 33(4): 314-316, 331.
3. 曲腾飞, 何向阳, 周斌, 等. 腹膜后肿瘤手术入路及相关技巧. 中华普通外科杂志, 2020, 35(6): 499-501.
4. 罗成华, 苗成利. 腹膜后肿瘤的手术治疗策略与新趋势. 中国普外基础与临床杂志, 2016, 23(3): 257-259.
5. 白猛. VR 技术在手术教学中的应用. 福建电脑, 2020, 36(8): 135-136.
6. Tzanis D, Bouhadiba T, Gaignard E, et al. Major vascular resections in retroperitoneal sarcoma. J Surg Oncol, 2018, 117(1): 42-47.
7. 中华医学会数字医学分会, 中国研究型医院学会数字医学临床外科专业委员会. 腹膜后肿瘤三维可视化精准诊治专家共识 (2018 版). 中国实用外科杂志, 2018, 38(12): 1347-1353.
8. 韩善清, 房加高, 陈爱萍, 等. 基于三维可视化技术的后腹膜肿瘤精准手术切除. 中国数字医学, 2020, 15(1): 58-60.
9. 卢家俊, 施云涛, 史向军, 等. 三维可视化技术在腹膜后肿瘤切除术中应用研究. 中国实用外科杂志, 2019, 39(9): 959-963.
10. 李菲菲. 基于 VR 技术的 3D 手术操作练习模拟器的设计与开发. 科技创新与应用, 2020, (16): 40-42.
11. Czeyda-Pommersheim F, Menias C, Boustani A, et al. Diagnostic approach to primary retroperitoneal pathologies: what the radiologist needs to know. Abdom Radiol (NY), 2020, [Online ahead of print].
12. Sugiyama T, Clapp T, Nelson J, et la. Immersive 3-Dimensional virtual reality modeling for case-specific presurgical discussions in cerebrovascular neurosurgery. Oper Neurosurg (Hagerstown), 2020, [Online ahead of print].
13. Lungu AJ, Swinkels W, Claesen L, et al. A review on the applications of virtual reality, augmented reality and mixed reality in surgical simulation: an extension to different kinds of surgery. Expert Rev Med Devices, 2020, [Online ahead of print].
14. Gronchi A, Strauss DC, Miceli R, et al. Variability in patterns of recurrence after resection of primary retroperitoneal sarcoma (RPS): a report on 1 007 patients from the Multi-Institutional Collaborative RPS Working Group. Ann Surg, 2016, 263(5): 1002-1009.
15. MacNeill AJ, Miceli R, Strauss DC, et al. Post-relapse outcomes after primary extended resection of retroperitoneal sarcoma: A report from the Trans-Atlantic RPS Working Group. Cancer, 2017, 123(11): 1971-1978.
16. Zaidi MY, Canter R, Cardona K. Post-operative surveillance in retroperitoneal soft tissue sarcoma: The importance of tumor histology in guiding strategy. J Surg Oncol, 2018, 117(1): 99-104.
17. Murez T, Fléchon A, Rocher L, et al. CCAFU french national guidelines 2016-2018 on retroperitoneal sarcoma. Prog Urol, 2016, 27 Suppl 1: S183-S190.
18. Hamilton TD, Cannell AJ, Kim M, et al. Results of resection for recurrent or residual retroperitoneal sarcoma after failed primary treatment. Ann Surg Oncol, 2017, 24(1): 211-218.
19. 李红丽, 郭占涛. 虚拟现实技术的应用及其不足. 信息通信, 2018, (12): 255-257.
20. 郭娜, 王田苗, 胡磊, 等. ACL 重建手术增强现实导航系统的人机交互技术. 计算机工程与应用, 2020, 56(21): 224-230.
21. 李宁, 曹志强. 增强现实、混合现实在泌尿外科导航手术中的应用. 中华腔镜泌尿外科杂志 (电子版), 2020, 14(4): 241-245.
22. Bremjit PJ, Jones RL, Chai X, et al. A contemporary large single-institution evaluation of resected retroperitoneal sarcoma. Ann Surg Oncol, 2014, 21(7): 2150-2158.
23. von Mehren M, Randall RL, Benjamin RS, et al. Soft Tissue Sarcoma, Version 2. 2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 2018, 16(5): 536-563.
24. 赵纪春, 陈熹阳. 累及大血管的腹膜后肿瘤的手术治疗. 中国普外基础与临床杂志, 2016, 23(3): 260-262.
25. 中华医学会外科学分会外科手术学学组, 中国抗癌协会肉瘤专业委员会, 中国医疗保健国际交流促进会软组织肿瘤分会, 等. 原发性腹膜后软组织肉瘤诊治中国专家共识 (2019 版). 中国实用外科杂志, 2019, 39(6): 526-532.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Discussion on three cases of retroperitoneal tumor involving great vessels by MDT mode under the aid of VR

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