Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2021; 13(12): 1754-1769
Published online Dec 27, 2021. doi: 10.4240/wjgs.v13.i12.1754
Current and future role of three-dimensional modelling technology in rectal cancer surgery: A systematic review
Anna Przedlacka, Gianluca Pellino, Jordan Fletcher, Fernando Bello, Paris P Tekkis, Christos Kontovounisios
Anna Przedlacka, Paris P Tekkis, Christos Kontovounisios, Department of Surgery and Cancer, Imperial College London, London SW10 9NH, United Kingdom
Gianluca Pellino, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, Naples 80138, Campania, Italy
Gianluca Pellino, Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona 08029, Spain
Gianluca Pellino, Paris P Tekkis, Christos Kontovounisios, Colorectal Surgery, Royal Marsden NHS Foundation Trust, London SW3 6JJ, United Kingdom
Jordan Fletcher, Department of Surgery and Cancer, St Mark’s Hospital Academic Institute, Imperial College London, London HA1 3UJ, United Kingdom
Fernando Bello, Centre for Engagement and Simulation Science, Imperial College London, London SW10 9NH, United Kingdom
Paris P Tekkis, Christos Kontovounisios, Colorectal Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London SW10 9NH, United Kingdom
Author contributions: Przedlacka A designed the research; Przedlacka A and Fletcher J performed the data search and screening; Przedlacka A, Pellino G and Kontovounisios C analysed the data; Przedlacka A drafted the manuscript; Pellino G, Kontovounisios C, Bello F and Tekkis PP revised the manuscript; All authors approved the final manuscript.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gianluca Pellino, MD, PhD, FRCS (Gen Surg), FEBS (Coloproctology), FASCRS, FACS, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, Piazza Miraglia 2, Naples 80138, Campania. gianluca.pellino@unicampania.it
Received: April 28, 2021
Peer-review started: April 28, 2021
First decision: June 17, 2021
Revised: June 9, 2021
Accepted: November 15, 2021
Article in press: November 15, 2021
Published online: December 27, 2021
Processing time: 239 Days and 16.4 Hours
ARTICLE HIGHLIGHTS
Research background

Three-dimensional (3D) modelling technology has been gaining an increasing interest in various surgical subspecialities and aspects of surgical care, such as operative planning and navigation, surgical education and patient interaction. However, the uptake of this novel technology lags behind in rectal cancer surgery.

Research motivation

The motivation of the current systematic review is to evaluate the role of 3D modelling technology in rectal cancer surgery and to provide the future directions for its development.

Research objectives

The systemic review aims to provide a comprehensive and up-to-date review of the current applications of 3D modelling technology in rectal cancer surgery and to identify its benefits and limitations.

Research methods

Electronic databases, PubMed/MEDLINE, Embase and Scopus, were searched to identify studies addressing the application of 3D models, both virtual and physical, in rectal cancer surgery between 2000 and 2020. All full-text studies were considered eligible. Animal and cadaveric studies, as well as studies of pelvic volumetry and radiotherapy planning were excluded.

Research results

Sixteen studies were found to be eligible for inclusion in the current systematic review, amongst which there was one single-centre open-label randomised controlled trial, 4 retrospective studies, 9 feasibility or pilot studies and 2 case reports. Thirteen studies described the use of virtual 3D models, one study evaluated 3D printed models and both types of models were described in two studies. The applications of 3D modelling technology in rectal cancer surgery could be divided into four categories: (1) Feasibility of application of 3D modelling technology in rectal cancer surgery; (2) Durgical planning and navigation; (3) Surgical education; and (4) Surgical device design.

Research conclusions

The 3D modelling technology is in its relative infancy in the field of rectal cancer surgery. While the creation of virtual and physical 3D models of rectal cancer and pelvic anatomy has been shown to be feasible, future developments in segmentation technique and 3D printing materials are needed to make it clinically relevant.

Research perspectives

Further well-designed randomised controlled studies are required to assess the fidelity of virtual and physical 3D models of rectal cancer and pelvic anatomy, and to evaluate the influence of their use on surgical and oncological outcomes in rectal cancer surgery.