Journal Article

Usefulness of three-dimensional printing of superior mesenteric vessels in right hemicolon cancer surgery

Bian, Linjie, Zou, Junyi, Xu, Jie, Wu, Danping, Gu, Chen, Fan, Xinqi, Xu, Zekuan, Xia, Jiazeng, Zhou, Hong, Liu, Zhequn, Chen, Yigang

2020

Overview

The anatomy of the superior mesenteric vessels is complex, yet important, for right-sided colorectal surgery. The usefulness of three-dimensional (3D) printing of these vessels in right hemicolon cancer surgery has rarely been reported. In this prospective clinical study, 61 patients who received laparoscopic surgery for right hemicolon cancer were preoperatively randomized into 3 groups: 3D-printing (20 patients), 3D-image (19 patients), and control (22 patients) groups. Surgery duration, bleeding volume, and number of lymph node dissections were designed to be the primary end points, whereas postoperative complications, post-operative flatus recovery time, duration of hospitalization, patient satisfaction, and medical expenses were designed to be secondary end points. To reduce the influence of including different surgeons in the study, the surgical team was divided into 2 groups based on surgical experience. The duration of surgery for the 3D-printing and 3D-image groups was significantly reduced (138.4 ± 19.5 and 154.7 ± 25.9 min vs. 177.6 ± 24.4 min, P  = 0.000 and P  = 0.006), while the number of lymph node dissections for the these 2 groups was significantly increased (19.1 ± 3.8 and 17.6 ± 3.9 vs. 15.8 ± 3.0, P  = 0.001 and P  = 0.024) compared to the control group. Meanwhile, the bleeding volume for the 3D-printing group was significantly reduced compared to the control group (75.8 ± 30.4 mL vs. 120.9 ± 39.1 mL, P  = 0.000). Moreover, patients in the 3D-printing group reported increased satisfaction in terms of effective communication compared to those in the 3D-image and control groups. Medical expenses decreased by 6.74% after the use of 3D-printing technology. Our results show that 3D-printing technology could reduce the duration of surgery and total bleeding volume and increase the number of lymph node dissections. 3D-printing technology may be more helpful for novice surgeons. Trial registration : Chinese Clinical Trial Registry, ChiCTR1800017161. Registered on 15 July 2018.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: 692/4020/1503/1504/1885/1393 / 692/4020/2199 / Aged / Aged, 80 and over / Bleeding / Blood Loss, Surgical - prevention & control / Cancer / Cancer surgery / Colon - blood supply / Colon - diagnostic imaging / Colon - pathology / Colon - surgery / Colorectal Neoplasms - blood supply / Colorectal Neoplasms - diagnostic imaging / Colorectal Neoplasms - pathology / Colorectal Neoplasms - surgery / Computed Tomography Angiography - economics / Computed Tomography Angiography - methods / Dissection / Female / Humanities and Social Sciences / Humans / Imaging, Three-Dimensional - economics / Imaging, Three-Dimensional - instrumentation / Imaging, Three-Dimensional - methods / Laparoscopy / Laparoscopy - methods / Length of Stay - economics / Length of Stay - statistics & numerical data / Lymph Node Excision - methods / Lymph nodes / Lymph Nodes - blood supply / Lymph Nodes - diagnostic imaging / Lymph Nodes - pathology / Lymph Nodes - surgery / Lymphatic system / Male / Mesenteric Artery, Superior - diagnostic imaging / Mesenteric Artery, Superior - surgery / Mesenteric Veins - diagnostic imaging / Mesenteric Veins - surgery / Mesentery - blood supply / Mesentery - diagnostic imaging / Mesentery - pathology / Mesentery - surgery / Middle Aged / multidisciplinary / Operative Time / Patient satisfaction / Patients / Printing / Printing, Three-Dimensional - economics / Printing, Three-Dimensional - instrumentation / Prospective Studies / Science / Science (multidisciplinary) / Surgeons / Surgery