3D打印技术在乳腺外科中的应用进展

摘要/Abstract

摘要： 3D打印技术自20世纪末诞生至今一直备受关注。近年来被广泛应用于生物医学各专科领域,例如术前个性化方案规划、术中导航、制作手术导板、医生临床教学、手术技能培训、医患沟通、个性化体内植入物打印、体内药物支架植入以及人体组织器官再生与细胞培养增殖等。在乳腺外科也得到广泛应用和深入研究,例如应用于保乳手术的术前肿瘤定位、术中个性化导板导航手术和支架置入以及术后局部化疗药物的置入和放疗靶区的精准定位;乳房重建手术中腹壁下血管穿支皮瓣的3D打印、乳房假体的体积计算和3D打印生物支架联合脂肪组织再生。总之,3D打印技术的广泛应用与深入研究,为乳腺外科的精准治疗提供了保障,推动了乳腺外科的数字化发展。

关键词: 3D打印, 乳腺外科, 应用

Abstract: 3D printing technology has attracted much attention since its birth at the end of the 20th century. In recent years, it has been widely used in various fields of biomedicine, such as preoperative personalized plan planning, intraoperative navigation, surgical guide production, clinical teaching of doctors, surgical skills training, doctor-patient communication, personalized in vivo implant printing, and in vivo drugs scaffold implantation, human tissue and organ regeneration, cell culture proliferation, etc. It has also been widely used and in-depth researched in breast surgery, such as preoperative tumor localization in breast-conserving surgery, intraoperative personalized guide navigation surgery and stent placement, postoperative placement of local chemotherapy drugs and precise positioning of radiotherapy target areas; 3D printing of inferior epigastric vessel perforator flap, volume calculation of breast prosthesis and 3D printing bioscaffold combined with adipose tissue regeneration in breast reconstruction surgery. In short, the extensive application and in-depth research of 3D printing technology provide guarantee for precise treatment of breast surgery and promote the digital development of breast surgery.

Key words: three-dimensional printing, breast surgery, application

中图分类号:

R655.8

王亚男, 梁俊青. 3D打印技术在乳腺外科中的应用进展[J]. 中华养生保健, 2024, 42(22): 64-67.

WANG Ya-nan, LIANG Jun-qing. Application of Three-dimensional Printing Technology in Breast Surgery[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(22): 64-67.

参考文献

[1] VENTOLA C L.Medical Applications for 3D Printing: Current and Projected Uses[J]. P T,2014,39(10):704-711.
[2] 卢秉恒,李涤尘.增材制造(3D打印)技术发展[J].机械制造与自动化,2013, 42(4):1-4.
[3] 孙晓亮,官建中,周建生,等.3D打印技术在髋关节手术中的应用进展[J].山东医药,2018,58(23):108-111.
[4] PUGLIESE L, MARCONI S, NEGRELLO E, et al.The clinical use of 3D printing in surgery[J]. Updates Surg,2018,70(3):381-388.
[5] MENG M, WANG J, SUN T, et al.Clinical applications and prospects of 3D printing guide templates in orthopaedics[J]. J Orthop Translat,2022,34:22-41.
[6] NOOR N, SHAPIRA A, EDRI R, et al.3D Printing of Personalized Thick and Perfusable Cardiac Patches and Hearts[J].Adv Sci (Weinh),2019,6(11):1900344.
[7] ISAACSON A, SWIOKLO S, CONNON C J.3D bioprinting of a corneal stroma equivalent[J]. Exp Eye Res,2018,173:188-193.
[8] XU X, AWAD A, ROBLES-MARTINEZ P, et al.Vat photopolymerization 3D printing for advanced drug delivery and medical device applications[J]. J Control Release,2021,329:743-757.
[9] 张聚良,延常姣,黄美玲,等.3D打印技术在保乳手术中应用进展[J].中国实用外科杂志,2019,39(11):1225-1227.
[10] SANTIAGO L, ADRADA B E, CAUDLE A S, et al.The role of three-dimensional printing in the surgical management of breast cancer[J]. J Surg Oncol,2019,120(6):897-902.
[11] BADAL A, CLARK M, GHAMMRAOUI B.Reproducing two-dimensional mammograms with three-dimensional printed phantoms[J]. J Med Imaging (Bellingham),2018,5(3):033501.
[12] HE Y, LIU Y, DYER B A, et al.3D-printed breast phantom for multi-purpose and multi-modality imaging[J]. Quant Imaging Med Surg,2019,9(1):63-74.
[13] ALI A, WAHAB R, HUYNH J, et al.Imaging properties of 3D printed breast phantoms for lesion localization and Core needle biopsy training[J].3D Print Med,2020,6(1):4.
[14] HAYES M K.Update on Preoperative Breast Localization[J]. Radiol Clin North Am,2017,55(3):591-603.
[15] BARTH RJ JR, KRISHNASWAMY V, PAULSEN K D, et al.A Patient-Specific 3D-Printed Form Accurately Transfers Supine MRI-Derived Tumor Localization Information to Guide Breast-Conserving Surgery[J]. Ann Surg Oncol,2017,24(10):2950-2956.
[16] WU Z Y, KIM H J, LEE J, et al.Breast-conserving surgery with 3D-printed surgical guide: a single-center, prospective clinical study[J]. Sci Rep,2021,11(1):2252.
[17] WU Z Y, KIM G B, CHOI S, et al.Breast-Conserving Surgery after Neoadjuvant Chemotherapy Using a Three-Dimensional-Printed Surgical Guide Based on Supine Magnetic Resonance Imaging: A Case Report[J]. J Breast Cancer,2021,24(2):235-240.
[18] LUO J, CHEN F, CAO H, et al.Customised 3D-Printed Surgical Guide for Breast-Conserving Surgery after Neoadjuvant Chemotherapy and Its Clinical Application[J]. Bioengineering (Basel),2023,10(11):1296.
[19] 张聚良,姚青,黄美玲,等.计算机辅助3D打印技术用于保留乳房手术一期乳房重建[J].中华乳腺病杂志(电子版),2018,12(1):12-16.
[20] HAO W, ZHENG Z, ZHU L, et al.3D printing-based drug-loaded implanted prosthesis to prevent breast cancer recurrence post-conserving surgery[J]. Asian J Pharm Sci,2021,16(1):86-96.
[21] MELCHELS F, WIGGENHAUSER P S, WARNE D, et al.CAD/CAM-assisted breast reconstruction[J]. Biofabrication,2011,3(3):034114.
[22] JABLONKA E M, WU R T, MITTERMILLER P A, et al.3-DIEPrinting: 3D-printed Models to Assist the Intramuscular Dissection in Abdominally Based Microsurgical Breast Reconstruction[J]. Plast Reconstr Surg Glob Open,2019,7(4):e2222.
[23] DEFAZIO M V, ARRIBAS E M, AHMAD F I, et al.Application of Three-Dimensional Printed Vascular Modeling as a Perioperative Guide to Perforator Mapping and Pedicle Dissection during Abdominal Flap Harvest for Breast Reconstruction[J]. J Reconstr Microsurg,2020,36(5):325-338.
[24] OGUNLEYE A A, DEPTULA P L, INCHAUSTE S M, et al.The utility of three-dimensional models in complex microsurgical reconstruction[J]. Arch Plast Surg,2020,47(5):428-434.
[25] HUMMELINK S, VERHULST A C, MAAL T J J, et al. Applications and limitations of using patient-specific 3D printed molds in autologous breast reconstruction[J]. Eur J Plast Surg,2018,41(5):571-576.
[26] SOTSUKA Y, MATSUDA K, FUJITA K, et al.A Perforator Model as an Aid to Elevate Deep Infe-rior Epigastric Perforator Flap[J]. Plast Reconstr Surg Glob Open,2015,3(7):e462.
[27] CHEN K, FENG C J, MA H, et al.Preoperative breast volume evaluation of one-stage immediate breast reconstruction using three-dimensional surface imaging and a printed mold[J]. J Chin Med Assoc,2019,82(9):732-739.
[28] PENG W, PENG Z, TANG P, et al.Review of Plastic Surgery Biomaterials and Current Progress in Their 3D Manufacturing Technology[J]. Materials (Basel),2020,13(18):4108.
[29] CHHAYA M P, MELCHELS F P, HOLZAPFEL B M, et al.Sustained regeneration of high-volume adipose tissue for breast reconstruction using computer aided design and biomanufacturing[J]. Biomaterials,2015,52:551-560.
[30] KHOO D, UNG O, BLOMBERGER D, et al.Nipple Reconstruction: A Regenerative Medicine Approach Using 3D-Printed Tissue Scaffolds[J]. Tissue Eng Part B Rev,2019,25(2):126-134.
[31] PATI F, HA D H, JANG J, et al.Biomimetic 3D tissue printing for soft tissue regeneration[J]. Biomaterials,2015,62:164-175.
[32] GALSTYAN A, BUNKER M J, LOBO F, et al.Applications of 3D printing in breast cancer management[J]. 3D Print Med,2021,7(1):19.
[33] SHI W, WANG J, GAO J, et al.Utilization of 3D printing technology in hepatopancreatobiliary surgery[J]. J Zhejiang Univ Sci B,2024,25(2):123-134.