Background: Effective preoperative patient counseling is essential to shared decision-making. In thyroid surgery, patient communication can be complicated by the complex anatomy and variable surgical approaches, which may not be fully conveyed through conventional verbal explanations or schematic drawings. Virtual three-dimensional (3D) thyroid models may provide an intuitive tool to enhance patient comprehension. Methods: We conducted a randomized controlled trial at Peking Union Medical College Hospital with 94 newly-diagnosed thyroid cancer patients scheduled for thyroidectomy. Participants were assigned to either the control group (n= 47), which received preoperative drawing-based counseling, or the intervention group (n= 47), which utilized a virtual 3D model for communication. The Thyroid Navigator app, developed by Kuma Hospital, was used to provide dynamic 3D representation of the thyroid gland, surrounding structures, and potential surgical procedures. After standardized preoperative consultations, patients were surveyed to assess their understanding in pertinent anatomy and postoperative complications. Results: Patients in the 3D model group demonstrated similar correct response rates in lesion localization (p= 0.536) or parathyroid gland recognition (p= 0.071), but significantly higher accuracy in identifying the recurrent laryngeal nerve and the extent of lymph node dissection compared with the control group (p< 0.05). Moreover, comprehension of the causes of major postoperative complications—including hoarseness (recurrent laryngeal nerve injury,p= 0.004), hypocalcemia (parathyroid gland impairment,p= 0.015), and bleeding (inadequate hemostasis,p= 0.008)—was significantly improved in the 3D model group. Conclusions: Use of a virtual 3D thyroid model significantly improves patient comprehension of thyroid anatomy, surgical procedures, and potential complications, thereby enhancing clinician–patient communication. Virtual 3D models represent a practical and cost-effective supplement to conventional counseling in thyroid surgery, offering clear benefits in patient education and shared decision-making.
背景：有效的术前患者沟通对共同决策至关重要。在甲状腺手术中，由于解剖结构复杂且手术方式多样，传统口头解释或示意图可能无法充分传达信息，这使得医患沟通变得复杂。虚拟三维甲状腺模型或可提供直观工具以提升患者理解。方法：我们在北京协和医院开展了一项随机对照试验，共纳入94例新诊断甲状腺癌并计划接受甲状腺切除术的患者。参与者被随机分为对照组（n=47，接受基于绘图术前沟通）与干预组（n=47，使用虚拟三维模型进行沟通）。研究采用日本隈病院开发的甲状腺导航应用程序，动态展示甲状腺三维结构、周边组织及可能的手术方案。在标准化术前咨询后，通过问卷调查评估患者对相关解剖及术后并发症的理解程度。结果：三维模型组患者在病灶定位（p=0.536）与甲状旁腺识别（p=0.071）方面的正确率与对照组相当，但在辨认喉返神经及淋巴结清扫范围方面准确率显著更高（p<0.05）。此外，该组对主要术后并发症成因的理解——包括声音嘶哑（喉返神经损伤，p=0.004）、低钙血症（甲状旁腺功能受损，p=0.015）及出血（止血不充分，p=0.008）——均得到显著提升。结论：应用虚拟三维甲状腺模型能显著提高患者对甲状腺解剖、手术步骤及潜在并发症的认知，从而优化医患沟通。该模型可作为甲状腺手术常规沟通中实用且具有成本效益的辅助工具，为患者教育和共同决策带来明显获益。
肿瘤(癌症)患者之家