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Meta-Analysis of the Effects of Three-Dimensional Visualized Medical Techniques Hepatectomy for Liver Cancer with and Without the Treatment of Sorafenib

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Abstract

Background: The application of medical image three-dimensional (3D) reconstruction technology can provide intuitive 3D image data support for accurate preoperative evaluation, surgical planning, and operation safety. However, there is still a lack of high-quality evidence to support whether 3D reconstruction technology is more advantageous in liver resection. Therefore, this study systematically evaluated the clinical effects of 3D reconstruction and two-dimensional (2D) image-assisted hepatectomy.

Methods: Databases were searched to collect published clinical studies on 3D reconstruction technology and 2D image-assisted liver resection. Data were extracted from the database construction to March 2022 and the risk of bias in the included studies was evaluated. Meta-analysis was performed using RevMan5.3 software.

Results: A total of 13 clinical studies were included, including 1616 patients, 795 in the 2D group and 819 in the 3D group. The meta-analysis showed that the incidence of postoperative complications was lower in the 3D group than in the 2D group (OR = 0.64, 95% CI = 0.49-0.83, =0.001) and also reduced operation time (SMD = -0.51, 95% CI = -0.74∼-0.27, < 0.0001), decreased intraoperative blood loss (SMD = -63.85, 95% CI = -98.66-29.04, =0.0003), decreased incidence of postoperative liver failure (OR = 2.42, 95% CI = 0.99-5.95, =0.05), decreased postoperative recurrence rate (OR = 0.29, 95% CI = 0.16-0.53, < 0.0001), and increased postoperative survival rate (OR = 2.19, 95% CI = 1.49-3.23, < 0.0001).

Conclusions: Current data suggest that 3D reconstruction-assisted hepatectomy can reduce intraoperative blood loss, postoperative complications, and recurrence, and improve postoperative survival. Therefore, the 3D reconstruction technique is worthy of application and promotion in assisted liver resection.

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