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Martinez-Ferro M, Bellia-Munzon G, Toselli L, Sanjurjo D. The role of 3D printing in chest wall reconstruction. J Thorac Dis 2024; 16:4053-4063. [PMID: 38983181 PMCID: PMC11228731 DOI: 10.21037/jtd-23-881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 05/08/2024] [Indexed: 07/11/2024]
Abstract
Technology is advancing fast, and chest wall surgery finds particular benefit in the broader availability of three-dimensional (3D) reconstruction and printing. An increasing number of reports are being published on the use of these resources in virtual 3D reconstructions of chest walls in computed tomography (CT) scans, virtual surgeries, 3D printing of real-size models for surgical planning, practice, and education, and of note, the manufacture of customized 3D printed implants, changing the fundamental conception from a surgery that fits all, to a surgery for each patient. In this review, we explore the evidence published on simple chest wall reconstruction, including the use of 3D technology to assist in the improvement of the repair of the most frequent chest wall deformities: pectus excavatum and carinatum. Current studies are oriented to the automatization and customization of transthoracic implants, as well as education on real-size models. Next, we investigate the implementation of 3D printing in the repair of complex chest wall reconstruction, comprised of infrequent chest wall deformities such as pectus arcuatum and Poland syndrome. These malformations are very heterogeneous resulting in a high degree of improvisation during the surgical repair. In this setting, 3D technology plays a role in the standardization of a process that contemplates customization, concepts that may seem contradictory. Finally, 3D printing with biocompatible materials is rapidly becoming the first choice for the reconstruction of wide chest wall oncological resections. In this work, we review the first and most important current publications on the subject.
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Affiliation(s)
- Marcelo Martinez-Ferro
- Fundacion Hospitalaria Mother and Child Medical Center, Buenos Aires, Argentina
- Clinica Mi Pectus, Capital Federal, Buenos Aires, Argentina
| | - Gaston Bellia-Munzon
- Fundacion Hospitalaria Mother and Child Medical Center, Buenos Aires, Argentina
- Clinica Mi Pectus, Capital Federal, Buenos Aires, Argentina
| | - Luzia Toselli
- Fundacion Hospitalaria Mother and Child Medical Center, Buenos Aires, Argentina
- Clinica Mi Pectus, Capital Federal, Buenos Aires, Argentina
| | - Daniela Sanjurjo
- Fundacion Hospitalaria Mother and Child Medical Center, Buenos Aires, Argentina
- Clinica Mi Pectus, Capital Federal, Buenos Aires, Argentina
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Zhou X, Zhang D, Xie Z, Yang Y, Feng L, Hou C, Chen M, Liang Z, Zhang G, Lu H. Application of preoperative 3D printing in the internal fixation of posterior rib fractures with embracing device: a cohort study. BMC Surg 2023; 23:237. [PMID: 37580688 PMCID: PMC10426142 DOI: 10.1186/s12893-023-02128-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/28/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND To explore the impact of preoperative 3D printing on the fixation of posterior rib fractures utilizing a memory alloy embracing device of rib under thoracoscopy. METHODS The enrolled patients were divided into the 3D printing (11 patients) and the non-3D printing (18 patients) groups, based on whether a 3D model of ribs was prepared prior to surgery. Analysis was conducted comparing the average fixation time per fracture, postoperative fixation loss, and poor reduction of fractured end between the two groups. RESULTS The average fixation time of each fracture was 27.2 ± 7.7 min in the 3D printing group and 29.3 ± 8.2 min in the non-3D printing group, with no statistically significant difference observed between the two groups (P > 0.05). The incidence of poor fracture fixation in the 3D printing group was statistically lower than that in the non-3D printing group (12.9% vs. 44.7%, P < 0.05). Further stratified analysis revealed that the off-plate rate in the 3D printing group and the non-3D group was (3.2% vs. 12.8%, P > 0.05), and the dislocation rate of the fractured end was (9.7% vs. 31.9%, P < 0.05). CONCLUSIONS The application of 3D printing technology to prepare the rib model before surgery is proves beneficial in reducing the occurrence of poor fixation of fractures and achieving precise and individualized treatment.
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Affiliation(s)
- Xuetao Zhou
- Department of Cardiothoracic Surgery, Shijiazhuang Third Hospital, No.15 Tiyu South Street, Chang an District, Shijiazhuang, 050000, Hebei Province, China
| | - Dongsheng Zhang
- Department of Cardiothoracic Surgery, Shijiazhuang Third Hospital, No.15 Tiyu South Street, Chang an District, Shijiazhuang, 050000, Hebei Province, China.
| | - Zexin Xie
- Department of Cardiothoracic Surgery, Shijiazhuang Third Hospital, No.15 Tiyu South Street, Chang an District, Shijiazhuang, 050000, Hebei Province, China
| | - Yang Yang
- Department of Cardiothoracic Surgery, Shijiazhuang Third Hospital, No.15 Tiyu South Street, Chang an District, Shijiazhuang, 050000, Hebei Province, China
| | - Lei Feng
- Department of Cardiothoracic Surgery, Shijiazhuang Third Hospital, No.15 Tiyu South Street, Chang an District, Shijiazhuang, 050000, Hebei Province, China
| | - Chunjuan Hou
- Department of Cardiothoracic Surgery, Shijiazhuang Third Hospital, No.15 Tiyu South Street, Chang an District, Shijiazhuang, 050000, Hebei Province, China
| | - Menghui Chen
- Department of Cardiothoracic Surgery, Shijiazhuang Third Hospital, No.15 Tiyu South Street, Chang an District, Shijiazhuang, 050000, Hebei Province, China
| | - Zheng Liang
- Department of Cardiothoracic Surgery, Shijiazhuang Third Hospital, No.15 Tiyu South Street, Chang an District, Shijiazhuang, 050000, Hebei Province, China
| | - Guoliang Zhang
- Department of Cardiothoracic Surgery, Shijiazhuang Third Hospital, No.15 Tiyu South Street, Chang an District, Shijiazhuang, 050000, Hebei Province, China
| | - Huiqing Lu
- Department of Cardiothoracic Surgery, Shijiazhuang Third Hospital, No.15 Tiyu South Street, Chang an District, Shijiazhuang, 050000, Hebei Province, China
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Young JS, McAllister M, Marshall MB. Three-dimensional technologies in chest wall resection and reconstruction. J Surg Oncol 2023; 127:336-342. [PMID: 36630098 DOI: 10.1002/jso.27164] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 01/12/2023]
Abstract
Resection and reconstruction of the chest wall can pose unique challenges given its vital role in the protection of the thoracic viscera and the dynamic part it plays in respiration. A number of new three-dimensional (3D) technologies may be invaluable in tackling these challenges. Herein we review the use of 3D technologies in preoperative imaging with virtual 3D models, printing of 3D models for preoperative planning, and printing of 3D prostheses when approaching complex chest wall reconstruction.
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Affiliation(s)
- John S Young
- Division of Thoracic and Cardiac Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Division of Thoracic Surgery, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA
| | - Miles McAllister
- Division of Thoracic and Cardiac Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - M Blair Marshall
- Division of Thoracic and Cardiac Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Liu L, Yan X, Liu J, Yan P, Du M, Wang R, Wu Y, Wang D. Risk assessment of severe postpartum hemorrhage after invasive placenta accreta based on three-dimensional reconstruction of magnetic resonance imaging. ANNALS OF TRANSLATIONAL MEDICINE 2023; 11:8. [PMID: 36760259 PMCID: PMC9906210 DOI: 10.21037/atm-22-2940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 10/08/2022] [Indexed: 01/12/2023]
Abstract
Background The aim of this study was to investigate the significance and feasibility of risk assessments based on the three-dimensional (3D) reconstruction of magnetic resonance imaging (MRI) of invasive placenta accreta (IPA) to create individualized surgical protocols and perioperative management plans in late pregnancy. Methods MRI and clinical data of 36 pregnant women with IPA admitted to Southwest Hospital from January 2017 to June 2021 were retrospectively analyzed. The patients were divided into the following 4 groups: peripartum hysterectomy (PH), abdominal aortic balloon block (AABB), PH with AABB, and nonsurgical treatment. Each group was then divided into severe and nonsevere postpartum hemorrhage subgroups based on postpartum hemorrhage volumes of not more than 2,000 mL and more than 2,000 mL, respectively. The uteri, placentas, IPA, and urinary bladders in each group were segmented and 3-dimensionally reconstructed using Amira 5.2.2 (Visage Imaging, Richmond, Australia) software, and their surface areas and volumes were calculated. A multifactorial unconditional logistic regression analysis was performed to evaluate the 3D morphological parameters of postpartum hemorrhage and calculate the optimal threshold. Results The bleeding volume, IPA area, placental area:uterine area ratio, IPA area:placental area ratio, maximum depth of IPA, placental position score, IPA position score, and implantation volume were greater in the severe postpartum hemorrhage subgroup than in the nonsevere postpartum hemorrhage subgroup of all groups. In the multifactorial regression analysis, the areas under the receiver operating characteristic curve of the implantation area, implantation volume, maximum depth of implantation, and implantation area:placental area ratio exceeded 0.9 and correlated strongly with severe postpartum hemorrhage, while those of the uterine area, uterine volume, placental area, placental volume, and placental area:uterine area ratio were between 0.5 and 0.7 and correlated with severe postpartum hemorrhage. The threshold (cutoff values) determining severe postpartum hemorrhage were 20,286.25 mm2 of the implantation area, 0.01271 of the implantation area:placental area ratio, 15.03 mm of the maximum depth of implantation, and 46,846 mm3 of the implantation volume. Conclusions The MRI 3D reconstruction of IPA and its adjacent structures can accurately display the location, anatomical morphology, and spatial relationship of IPA, which can be used to improve the accuracy of IPA diagnosis, predict postpartum hemorrhage, and provide optimized treatment decisions for obstetricians.
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Affiliation(s)
- Liqun Liu
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xiaoli Yan
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jingjing Liu
- Department of Digital Medicine, College of Biomedical Engineering and Medical Imaging, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ping Yan
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Mingshan Du
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Runyuan Wang
- Department of Digital Medicine, College of Biomedical Engineering and Medical Imaging, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yi Wu
- Department of Digital Medicine, College of Biomedical Engineering and Medical Imaging, Army Medical University (Third Military Medical University), Chongqing, China
| | - Dan Wang
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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Tongxin L, Jing X, Runyuan W, Wei W, Yu Z, Dong W, Wang H, Yi W, Ping H, Yong F. Application Research of Three-Dimensional Printing Technology and Three-Dimensional Computed Tomography in Segmentectomy. Front Surg 2022; 9:881076. [PMID: 35574524 PMCID: PMC9100398 DOI: 10.3389/fsurg.2022.881076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTo compare the application of the emerging 3D printing technology and 3D-CT in segmentectomy. And to explore the advantages of 3D printing technology in thoracoscopic segmentectomy.MethodsWe collected the clinical data of 118 patients undergoing thoracoscopic segmentectomy from January 2019 to April 2021 at the Thoracic Surgery Department, the Dianjiang People's Hospital of Chongqing and Southwest Hospital. Among them, 61 patients were in the 3D printing group and 57 patients were in the 3D-CT group respectively. The perioperative data of these two groups of patients were analyzed respectively.ResultsThere were no significant differences between the two groups in age, gender, tumor diameter, pathology, the preoperative complications of diabetes and heart disease. However, the patients with the complications of hypertension in the 3D printing group are significantly more than the 3D-CT group (P = 0.003). Compared with the 3D-CT group, patients in the 3D printing group had significantly shorter operation time (162.7 ± 47.0 vs. 190.3 ± 56.9 min, P = 0.006), less intraoperative fluid input (1,158.5 ± 290.2 vs. 1,433.2 ± 653.3, P = 0.013), and less total intraoperative fluid output, including intraoperative blood loss, urine excretion, and other fluid loss. In addition, there were no statistically significant differences in intraoperative blood loss, 24 h pleural fluid volume, 48 h pleural fluid volume, postoperative chest tube duration, postoperative hospital stay and complications between the two groups of patients (P > 0.05).ConclusionsIn thoracoscopic segmentectomy, the application of 3D printing technology shortens the operation time, reduces intraoperative fluid input and output, guides the operation more safely and effectively, and has better clinical application value.
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Affiliation(s)
- Li Tongxin
- Clinical Medicine Department, North Sichuan Medical College, Nanchong, Sichuan, China
- Cardiothoracic Surgery Department, Dianjiang People’s Hospital of Chongqing, Chongqing, China
| | - Xu Jing
- Health Economy Department, Southwest Hospital, Chongqing, China
| | - Wang Runyuan
- Digital Medicine Department, Biomedical Engineering College, Army Military Medical University, Chongqing, China
| | - Wu Wei
- Thoracic Surgery Department, Southwest Hospital, Chongqing, China
| | - Zhou Yu
- Cardiothoracic Surgery Department, Dianjiang People’s Hospital of Chongqing, Chongqing, China
| | - Wang Dong
- Cardiothoracic Surgery Department, Dianjiang People’s Hospital of Chongqing, Chongqing, China
| | - He Wang
- Cardiothoracic Surgery Department, Dianjiang People’s Hospital of Chongqing, Chongqing, China
| | - Wu Yi
- Digital Medicine Department, Biomedical Engineering College, Army Military Medical University, Chongqing, China
| | - He Ping
- Cardic Surgery Department, Southwest Hospital, Chongqing, China
- Correspondence: He Ping Fu Yong
| | - Fu Yong
- Clinical Medicine Department, North Sichuan Medical College, Nanchong, Sichuan, China
- Cardiothoracic Surgery Department, Dianjiang People’s Hospital of Chongqing, Chongqing, China
- Correspondence: He Ping Fu Yong
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