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The impact of three-dimensional reconstruction on laparoscopic-assisted surgery for right-sided colon cancer
Ryoichi Miyamoto1, Sosuke Tadano1, Naoki Sano1
1Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan.
Introduction:
During laparoscopic-assisted colorectal surgery (LACS) for right-sided colon cancer patients, we performed three-dimensional (3D) surgical simulation to investigate vascular anatomy, including the ileocolic artery (ICA), right colic artery (RCA) and superior mesenteric vein (SMV).
Aim:
We also used 3D imaging to examine the shortest distance from the root of the ileocolic vein (ICV) to the gastrocolic trunk (GCT).
Material And Methods:
We analyzed 46 right-sided colon cancer patients who underwent 3D-simulated LACS. We also examined a control group of 20 right-sided colon cancer patients who underwent LACS without 3D imaging. Patients who received such assessments were classified into the following two groups based on the vessel arrangement patterns of the ICA and SMV: the type A group, in which the ICA crosses anterior to the SMV, and the type B group, in which the ICA crosses posterior to the SMV. The shortest length from the root of the ICV to the GCT (D mm) was measured via 3D imaging. Patient characteristics and perioperative outcomes for these three groups were compared.
Results:
The mean D mm for all cases was 29.2 ±5.21 mm. Mean D mm values for the type A and type B groups were 27.8 ±4.21 and 30.5 ±5.53 mm, respectively. Intraoperative blood loss was lower in the type A group (41.8 ±27.5 g) and the type B group (44.5 ±31.6 g) than that in the control group (86.8 ±27.5 g) (p = 0.013).
Conclusions:
3D imaging was useful for understanding anatomical relationships during LACS.
