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Three-dimensional virtual planning for nodule resection in solid organs: A systematic review and meta-analysis
Matheus Zanon1, Stephan Altmayer2, Guilherme Watte3
1Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre - R, Sarmento Leite, 245, Porto Alegre, 90050170, Brazil; Medical Imaging Research Lab, LABIMED, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre - Av, Independência, 75, Porto Alegre, 90020160, Brazil.
Objectives:
To systematically review the effects of 3D-imaging virtual planning for nodule resection in the following solid organs: lung, liver, and kidney.
Methods:
MEDLINE, EMBASE, and Cochrane Library were searched through September 31, 2020 to include randomized and non-randomized controlled studies that compared outcomes of surgical resection of lung, liver, or kidney nodule resection with and without 3D virtual planning with computed tomography. From each article, the mean operation time (OT), mean estimated blood loss (EBL), mean postoperative hospital stay (POHS), and the number of postoperative events (POE) were extracted. The effect size (ES) of 3D virtual planning vs. non-3D planning was extracted from each study to calculate the pooled measurements for continuous variables (OT, EBL, POHS). Data were pooled using a random-effects model.
Results:
The literature search yielded 2397 studies and 10 met the inclusion criteria with a total of 897 patients. There was a significant difference in OT between groups with a moderate ES favoring the 3D group (ES,-0.56; 95%CI: 0.91,-0.29; I2 = 83.1%; p < .001). Regarding EBL, there was a significant difference between 3D and non-3D with a small ES favoring IGS (ES,-0.18; 95%CI: 0.33,-0.02; I2 = 22.5%; p = .0236). There was no difference between the 3D and non-3D groups for both POHS (POHS ES,-0.15; 95%CI: 0.39,0.10; I2 = 37.0%; p = .174) and POE (POE odds ratio (OR),0.80; 95%CI:0.54,1.19; I2 = 0.0%; p = .0.973).
Conclusions:
3D-imaging planning for surgical resection of lung, kidney, and liver nodules could reduce OT and EBL with no effects on immediate POHS and POE. Improvements in these perioperative variables could improve medium and long-term postoperative clinical outcomes.
Insights
Three-dimensional (3D) virtual planning for lung, liver, and kidney nodule resection significantly reduces operation time and blood loss. This advanced imaging technique does not impact immediate postoperative hospital stay or events, potentially improving long-term outcomes.
Area of Science:
- Surgical Oncology
- Medical Imaging
- Data Science
Background:
- Solid organ nodule resection is a common surgical procedure.
- Accurate pre-operative planning is crucial for successful surgical outcomes.
- Traditional planning methods may have limitations in complex cases.
Purpose of the Study:
- To systematically review the impact of 3D-imaging virtual planning on surgical outcomes for lung, liver, and kidney nodule resections.
- To compare operative time, blood loss, hospital stay, and postoperative events between 3D virtual planning and conventional methods.
- To assess the potential of 3D planning to enhance perioperative and long-term clinical results.
Main Methods:
- A systematic review of randomized and non-randomized controlled studies was conducted.
- Databases searched included MEDLINE, EMBASE, and Cochrane Library up to September 2020.
- Data extracted included operation time, estimated blood loss, postoperative hospital stay, and postoperative events, analyzed using a random-effects model.
Main Results:
- Ten studies with 897 patients met the inclusion criteria.
- 3D virtual planning significantly reduced operation time (moderate effect size) and estimated blood loss (small effect size).
- No significant differences were observed in postoperative hospital stay or postoperative events between 3D and non-3D planning groups.
Conclusions:
- 3D-imaging virtual planning is effective in reducing operative time and blood loss during lung, kidney, and liver nodule resections.
- The technology shows no adverse effect on immediate postoperative outcomes like hospital stay or complications.
- Enhanced perioperative efficiency through 3D planning may lead to improved medium and long-term clinical results.
