摘要目的:通过与二维影像的对比，分析计算机辅助手术系统三维成像在小儿肝中叶肿瘤术前手术规划中的临床指导作用。方法:回顾性分析2016年1月至2021年6月在青岛大学附属医院行肝中叶肿瘤手术的23例患儿临床资料，其中男16例，女7例；手术时平均年龄为22.3个月。术前通过观察二维CT影像初步制定手术切除方案，再对同一患儿行肝中叶肿瘤的三维成像，由同资历医生进行深度分析并最终制定手术切除方案，比较两种方案的差异。结果:所有患儿均按照计算机辅助手术系统规划成功切除肿瘤，所有患儿随访均获得良好的预后。其中9例患儿经三维重建评估后肿瘤与血管的特殊位置关系、血管变异程度或残肝体积的大小均与二维影响结果差异较大，按三维成像修改手术方案后手术成功进行，剩余残肝体积增大。结论:计算机辅助手术系统三维成像对小儿肝中叶肿瘤术前手术规划效果明显优于二维影像。

abstractsObjective:To explore the clinical guidance role of computer-aided surgery (CAS) system in preoperative surgical planning of pediatric middle lobe tumors in children.Methods:A retrospective analysis was performed for 23 children undergoing surgery of middle hepatic tumor at Qingdao University's Affiliated Hospital from January 2016 to June 2021.There were 16 boys and 7 girls with an average operative age of 22.3 months.Surgical resection plans were formulated through the preoperative two-dimensional CT images.After in-depth analysis, surgical resections were planned by three-dimensional imaging of middle hepatic tumor.And the feasibility of two schemes was compared.Results:All tumors were successfully removed according to CAS planning.All outcomes were decent.Nine children underwent three-dimensional reconstruction evaluation.Significant differences existed in special location relationship between tumor and blood vessels, degree of vascular variation, or residual liver volume compared to the two-dimensional imaging results.After modifying surgical plan according to three-dimensional imaging, surgery was successfully performed and residual liver volume increased.Conclusions:Three-dimensional imaging of CAS system is superior to two-dimensional imaging in preoperative planning of pediatric hepatoblastoma.