Application value of 3D printing technology in preoperative evaluation of laparoscopic radical resection of right colon cancer / 中华消化外科杂志

ABSTRACT

Objective:To investigate the application value of 3D printing technology in preoperative evaluation of laparoscopic radical resection of right colon cancer.Methods:The prospective study was conducted. The clinical data of 60 patients with right colon cancer who were admitted to the Affiliated Wuxi Second People′s Hospital of Nanjing Medical University from January to November of 2019 were collected. Patients were randomly divided into two groups by random number method. All the 60 patients were examined by plain scan and enhanced X-ray computed tomography (CT) preoperatively. Patients with vascular images printed into a 1∶1 full simulation entity using the 3D printing technology were divided into 3D printing group, and patients who only completed the plain scan and enhanced CT examination were divided into control group. All the 60 patients underwent laparoscopic complete mesocolic excision for right colon cancer. Observation indicators (1) anatomic courses of Henle trunk of the 3D printing group in the preoperative 3D printing models and their consistency with intraoperative anatomic courses; (2) intraoperative and postoperative situations of two groups. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the independent-sample t test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Results:A total of 60 patients were selected for eligibility, including 42 males and 18 females, aged (64±7)years, with a range from 44 to 78 years. Of the 60 patients, 30 were in the 3D printing group and 30 were in the control group. (1) Anatomic courses of Henle trunk of the 3D printing group in the preoperative 3D printing models and their consistency with intraoperative anatomic courses Henle trunk was observed in 28 of the 30 patients in the 3D printing group. Of the 28 patients, 7 had the gastropancreatic trunk of 2 branches formed with the right gastroepiploic vein and the superior anterior pancreaticoduodenal vein, 13 had the gastrocolonic trunk of 2 or 3 branches formed with the right gastroepiploic vein, the middle colonic vein and (or) the right colonic vein (including 4 cases with gastrocolonic trunk of 2 branches formed with the right gastroepiploic vein and the middle colonic vein, 6 cases with gastrocolonic trunk of 2 branches formed with the right gastroepiploic vein and the right colonic vein, 3 cases with gastrocolonic trunk of 3 branches formed with the right gastroepiploic vein, the middle colonic vein and the right colonic vein), 8 had the gastropancreaticocolonic trunk of 3 or 4 branches formed with the right gastroepiploic vein, the superior anterior pancreaticoduodenal vein, the right colonic vein and (or) the middle colonic vein (including 4 cases with gastropancreaticocolonic trunk of 3 branches formed with the right gastroepiploic vein, the superior anterior pancreaticoduodenal vein and the middle colonic vein, 2 cases with gastropancreaticocolonic trunk of 3 branches formed with the right gastroepiploic vein, the superior anterior pancreaticoduodenal vein and the right colonic vein, 2 cases with gastropancreaticocolonic trunk of 4 branches formed with the right gastroepiploic vein, the superior anterior pancreaticoduodenal vein, the right colonic vein and the middle colonic vein). The consistency of anatomic courses of Henle trunk of the 28 patients in the preoperative 3D printing models with intraoperative anatomic courses of bared Henle trunk was 100%(28/28). (2) Intraoperative and postoperative situations of two groups the operation time, volume of intraoperative blood loss, the numbers of lymph node dissected, cases with postoperative complications (cases with incision infection, cases with intestinal obstruction, cases with anastomotic leakage, cases with pulmonary infection), postoperative duration of hospital of the 3D printing group were (147±18)minutes, (79±29)mL, 19.1±2.8, 3 (1, 1, 0, 1), (9.0±2.5)days, respectively. The above indicators of the control group were (172±16)minutes, (118±17)mL, 15.6±2.6, 4(1, 1, 1, 1), (9.1±2.6)days, respectively. There were significant differences in the operation time, volume of intraoperative blood loss, the numbers of lymph node dissected between the two groups ( t=-5.630, -18.400, 3.318, P<0.05), and there was no significant difference in the cases with postoperative complications and postoperative duration of hospital between the two groups ( χ2=0.875, t=0.103, P>0.05). Conclusion:For laparoscopic right colon cancer radical resection, 3D printing technology can effectively evaluate the preoperative vascular anatomic courses, which can shorten operation time, reduce volume of intraoperative blood loss and improve the number of lymph node dissected. Trial Registration This study was registrated at Chinese Clinical Trail Registry with the registration number of ChiCTR1800017161.