目的: 评价3D打印模型拓片定位技术在腹腔镜保留肾单位手术中定位内生性肾癌的初步应用价值.方法: 2016年8月～2017年2月间,本院共收治4例内生性肾癌患者.肿瘤位于左侧2例,右侧2例;平均直径3.6(2.9～4.7)cm.采集患者CT断层扫面的图像数据,3 D打印制作内生性肾癌的"洞口"肾脏模型.采用拓印技术制作肾脏背侧面或腹侧面拓片,并拓印出肿瘤"洞口".均施行腹腔镜保留肾单位手术,术中将制作好的软质拓片边缘与肾脏周缘完全重叠,在肾脏表面拓印出肿瘤"洞口".结果: 本组4例腹腔镜保留肾单位手术中均准确定位出内生性肾癌.手术平均时间126.8 min(94～165 min),其中平均肿瘤定位时间9.5 min(6～15 min);术中平均热缺血时间23.5 min(19～29 min),术中平均失血量150 mL(80～280 mL).术中肉眼及术后病理学观察肾癌组织完整.结论: 3D打印模型拓片定位技术在腹腔镜保留肾单位手术中可直观、准确地定位内生性肾癌.%Objective: To evaluate the preliminary application value of the positioning technology about the 3D-printed model rubbings in laparoscopic nephron-sparing surgery for endophytic renal carcinoma. Methods: From August 2016 to February 2017, 4 patients with endogenous renal cell carcinoma were treated in our hospital. The tumor was located on the left in 2 cases and on the right in 2 cases, with an average diameter of 3. 6 (2. 9 ～ 4. 7) cm. The CT date scan of the patients were collected, and the " hole" kidney models of endophytic renal carcinoma were created with 3D printer. The topographic technique was used to make the dorsal or ventral rubbings of the kidney, and the tumor orifice was printed. Laparoscopic nephron-sparing surgery was performed. The edges of the soft rubbings were completely overlapped with the periphery of the kidney, and the tumor " orifice" was printed on the renal surface. Results: The 4 cases of endophytic renal carcinoma were accurately located in laparoscopic nephron-sparing surgery. The mean operation time was 126. 8 min(94 ～ 165 min) and the average tumor positioning time was 9. 5 min (6 ～ 15 min); the mean time of hot ischemia was 23. 5 min (19 ～ 29 min), and the average blood loss was 150 mL (80 ～ 280 mL). The integrity of renal carcinoma tissue was observed by naked-eye during the operation and by postoperative pathological observation. Conclusion: Positioning technology about the the 3D-printed model rubbings can locate endogenous renal cell carcinoma directly and accurately in laparoscopic nephron-sparing surgery.
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