Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2020; 8(4): 806-814
Published online Feb 26, 2020. doi: 10.12998/wjcc.v8.i4.806
Using Materialise's interactive medical image control system to reconstruct a model of a patient with rectal cancer and situs inversus totalis: A case report
Tao Chen, Yu-Tao Que, Yi-Hao Zhang, Fei-Yu Long, Yi Li, Xin Huang, Ya-Nan Wang, Yan-Feng Hu, Jiang Yu, Guo-Xin Li
Tao Chen, Yu-Tao Que, Yi-Hao Zhang, Fei-Yu Long, Xin Huang, Ya-Nan Wang, Yan-Feng Hu, Jiang Yu, Guo-Xin Li, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Yi Li, Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Author contributions: Zhang YH, Que YT, and Long FY analyzed and summed up the literature; Li Y, Que YT, Long FY, and Huang X reconstructed the three-dimensional model; Chen T, Wang YN, Hu YF, Yu J, and Li GX diagnosed and treated the patient.
Supported by the State's Key Project of Research and Development Plan, No. 2017YFC0108300 and No. 2017YFC0108303.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: 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/
Corresponding author: Tao Chen, MD, PhD, Associate Specialist, Attending Doctor, Department of General Surgery, Nanfang Hospital, Southern Medical University, No. 1838, North Guangzhou Avenue, Guangzhou 510515, Guangdong Province, China. drchentao@163.com
Received: October 1, 2019
Peer-review started: October 1, 2019
First decision: November 4, 2019
Revised: December 11, 2019
Accepted: December 14, 2019
Article in press: December 14, 2019
Published online: February 26, 2020
Processing time: 148 Days and 0.9 Hours
Abstract
BACKGROUND

Situs inversus totalis (SIT) is a rare congenital anomaly that refers to a completely reversed location of abdominal and thoracic organs. An extremely small number of patients with this condition, especially those with rectal neoplasms, have been reported. Surgery in these patients is technically challenging. Therefore, we reconstructed a three-dimensional (3D) digital model with the Materialise’s interactive medical image control system (Mimics) as a guide for laparoscopic resection.

CASE SUMMARY

We report the case of a 68-year-old woman with rectal neoplasms and SIT diagnosed by electronic colonoscopy biopsy and enhanced computed tomography (CT), which showed that there was a soft tissue mass protruding into the lumen in the lower rectal segment, a lesion that involved the serosal layer, multiple enlarged peripheral lymph nodes, and visceral situs abnormalities. Based on the CT images, we reconstructed a 3D model with Mimics to assist with our surgical planning. Then, we performed laparoscopy-assisted radical resection of the rectal neoplasms and total excision of the lesion. Adjuvant chemotherapy with the XELOX regimen (oxaliplatin 150 mg, D1 + Xeloda 1.0 g, Bid, D1-14) was initiated 1 mo after the operation. The patient recovered well after surgery, and her physical condition remained stable.

CONCLUSION

Preoperative 3D reconstruction of the imaging results could help reduce the unknown risks during surgery caused by anatomical abnormalities and improve the perioperative safety for patients.

Keywords: Rectal neoplasm; Situs inversus totalis; Laparoscopy; Three-dimensional reconstruction; Case report

Core tip: This case is the first to use the Materialise’s interactive medical image control system (Mimics) to reconstruct a three-dimensional (3D) model using computed tomography images of a patient with situs inversus totalis and rectal neoplasms, which helped to get a better understanding of anatomical structures and make preoperative plans. The more details of anatomy surgeons grasp, the less operating time is needed, and this could improve the quality of surgery and thereby enhance the perioperative safety of patients. Mimics is easy to operate and visually displays 3D anatomical structure, which shows advantages in patients with rare anatomical changes.