Zhao ZX, Hu ZJ, Yao RD, Su XY, Zhu S, Sun J, Yao Y. Three-dimensional printing for preoperative rehearsal and intraoperative navigation during laparoscopic rectal cancer surgery with left colic artery preservation. World J Gastrointest Surg 2024; 16(10): 3104-3113 [DOI: 10.4240/wjgs.v16.i10.3104]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Oct 27, 2024; 16(10): 3104-3113 Published online Oct 27, 2024. doi: 10.4240/wjgs.v16.i10.3104
Three-dimensional printing for preoperative rehearsal and intraoperative navigation during laparoscopic rectal cancer surgery with left colic artery preservation
Zong-Xian Zhao, Zong-Ju Hu, Run-Dong Yao, Xin-Yu Su, Shu Zhu, Jie Sun, Yuan Yao
Zong-Xian Zhao, Zong-Ju Hu, Run-Dong Yao, Xin-Yu Su, Shu Zhu, Jie Sun, Yuan Yao, Department of Anorectal Surgery, Fuyang People’s Hospital, Fuyang 236000, Anhui Province, China
Author contributions: Zhao ZX designed the study and wrote the manuscript; Hu ZJ instructed the whole study and prepared the figures; Su XY and Zhu S collected and analyzed the data; Yao RD and Sun J assisted in the collection of imaging data; Hu ZJ and Yao Y performed the operations; all authors have approved the final version of the manuscript.
Supported bythe Health Commission of Fuyang City, No. FY2021-18; Bengbu Medical College of Bengbu City, No. 2023byzd215; and the Health Commission Anhui Provence, No. AHWJ2023BAa20164.
Institutional review board statement: All procedures involving human participants were in accordance with the ethical standards of the institutional and national research committees and Helsinki Declaration and its later amendments. The study was approved by the institutional review board, Approval No. [2024]48.
Informed consent statement: Signed informed consent was obtained from all participants. Patient anonymity has been maintained.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: August 4, 2024 Revised: August 29, 2024 Accepted: September 12, 2024 Published online: October 27, 2024 Processing time: 53 Days and 15.8 Hours
Abstract
BACKGROUND
Prior studies have shown that preserving the left colic artery (LCA) during laparoscopic radical resection for rectal cancer (RC) can reduce the occurrence of anastomotic leakage (AL), without compromising oncological outcomes. However, anatomical variations in the branches of the inferior mesenteric artery (IMA) and LCA present significant surgical challenges. In this study, we present our novel three dimensional (3D) printed IMA model designed to facilitate preoperative rehearsal and intraoperative navigation to analyze its impact on surgical safety.
AIM
To investigate the effect of 3D IMA models on preserving the LCA during RC surgery.
METHODS
We retrospectively collected clinical dates from patients with RC who underwent laparoscopic radical resection from January 2022 to May 2024 at Fuyang People’s Hospital. Patients were divided into the 3D printing and control groups for statistical analysis of perioperative characteristics.
RESULTS
The 3D printing observation group comprised of 72 patients, while the control group comprised 68 patients. The operation time (174.5 ± 38.2 minutes vs 198.5 ± 49.6 minutes, P = 0.002), intraoperative blood loss (43.9 ± 31.3 mL vs 58.2 ± 30.8 mL, P = 0.005), duration of hospitalization (13.1 ± 3.1 days vs 15.9 ± 5.6 days, P < 0.001), postoperative recovery time (8.6 ± 2.6 days vs 10.5 ± 4.9 days, P = 0.007), and the postoperative complication rate (P < 0.05) were all significantly lower in the observation group.
CONCLUSION
Utilization of a 3D-printed IMA model in laparoscopic radical resection of RC can assist surgeons in understanding the LCA anatomy preoperatively, thereby reducing intraoperative bleeding and shortening operating time, demonstrating better clinical application potential.
Core Tip: Anastomotic leakage is one of the most challenging postoperative complications for surgeons operating on rectal cancer. Preserving the left colic artery significantly reduces the incidence of anastomotic leakage; however, achieving this outcome is technically demanding and time-consuming, particularly for less experienced surgeons. The present study suggests that three-dimensional printing technology can be effectively applied for preoperative simulation to improve intraoperative navigation. This approach helps surgeons optimize the surgical plan, reduces intraoperative bleeding, and shortens operation time.
