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

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, $P=0.001$ ) and also reduced operation time (SMD = −0.51, 95% CI = −0.74∼−0.27, $P<0.0001$ ), decreased intraoperative blood loss (SMD = −63.85, 95% CI = −98.66–29.04, $P=0.0003$ ), decreased incidence of postoperative liver failure (OR = 2.42, 95% CI = 0.99–5.95, $P=0.05$ ), decreased postoperative recurrence rate (OR = 0.29, 95% CI = 0.16–0.53, $P<0.0001$ ), and increased postoperative survival rate (OR = 2.19, 95% CI = 1.49–3.23, $P<0.0001$ ). 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.