Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
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 by the 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/
Corresponding author: Zong-Ju Hu, MD, Chief Doctor, Department of Anorectal Surgery, Fuyang People’s Hospital, No. 501 Sanqing Road, Yingzhou District, Fuyang 236000, Anhui Province, China. hzj130123@126.com
Received: August 4, 2024
Revised: August 29, 2024
Accepted: September 12, 2024
Published online: October 27, 2024
Processing time: 54 Days and 14.1 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.

Keywords: Rectal cancer; Three-dimensional printing; Inferior mesenteric artery; Left colic artery; Preoperative rehearsal; Intraoperative navigation

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.