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World J Gastrointest Surg. May 27, 2026; 18(5): 119094
Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.119094
Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.119094
Clinical value of computed tomography-based three-dimensional reconstruction of the pelvis and mesorectum in middle to low rectal carcinoma
Fei-Yue Ke, Department of Anorectal Surgery, Yongjia People’s Hospital, Wenzhou 325100, Zhejiang Province, China
Hao Chen, Department of Vascular Surgery, Wenzhou Central Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Ji-Sheng Liu, Wen-Cai Li, Department of Gastrointestinal and Hernia Surgery, Wenzhou Central Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Gaurav Dhamija, Department of General Medicine, Ram Krishna Medical College Hospital and Research Centre, Bhopal 462042, Madhya Pradesh, India
Ruchi Dharamshibhai Viroja, Department of Obstetric and Gynaecology, Bhavsinhji General Hospital, Porbandar 360575, Gujarāt, India
Gui-Ping Chen, Xiao-Cong Zhou, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou 310006, Zhejiang Province, China
Co-first authors: Fei-Yue Ke and Hao Chen.
Co-corresponding authors: Gui-Ping Chen and Xiao-Cong Zhou.
Author contributions: Ke FY and Chen H contributed equally to this work as co-first authors; Ke FY, Chen H and Zhou XC designed the study; Ke FY, Chen H, Liu JS and Li WC collected the data; Ke FY, Chen H and Dhamija G performed statistical analysis; Dhamija G and Viroja RD assisted with data interpretation and performed the language revision of the manuscript; Chen GP and Zhou XC supervised the study and critically revised the manuscript; they contributed equally to this work as co-corresponding authors; all authors read and approved the final manuscript.
Supported by the Public Welfare Technology Research Plan Project of Zhejiang Province, No. LGC21H160002; and the Basic Scientific Research Projects in Wenzhou City, Zhejiang Province, China, No. Y20220885.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Wenzhou Central Hospital (Approval No. K2018-01-003).
Informed consent statement: Informed consent was waived by the Institutional Review Board because this was a retrospective study using de-identified patient data, and no additional interventions or procedures were performed.
Conflict-of-interest statement: The authors declare that they have no conflict of interest related to this study.
Data sharing statement: Although informed consent was not obtained, the presented data are anonymized and risk of identification is low. For further information, reasonable requests may be submitted to the corresponding author. Technical appendix, statistical code, and dataset available from the corresponding author at bobzxccc@163.com.
Corresponding author: Xiao-Cong Zhou, PhD, Chief Physician, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), No. 54 Youdian Road, Shangcheng District, Hangzhou 310006, Zhejiang Province, China. bobzxccc@163.com
Received: January 21, 2026
Revised: February 14, 2026
Accepted: March 23, 2026
Published online: May 27, 2026
Processing time: 128 Days and 3.9 Hours
Revised: February 14, 2026
Accepted: March 23, 2026
Published online: May 27, 2026
Processing time: 128 Days and 3.9 Hours
Core Tip
Core Tip: The primary innovation of this study lies in the precise measurement of pelvic volume, rectal mesenteric volume, and rectal mesenteric fat volume using three-dimensional (3D) reconstruction. The 3D computed tomography-based reconstruction and measurement of the pelvis and mesorectum reveal clear, clinically relevant sex-related differences and provide precise parameters for defining a difficult pelvis. This method offers significant potential to enhance preoperative planning, guide personalized surgical strategies, and optimize outcomes in laparoscopic anus-preserving rectal cancer surgery.