3D reconstructions in rectal cancer. New tools for better diagnosis and surgical planning

Surgical planning in locally advanced rectal cancer (LARC) is essential to reduce morbidity and mortality and to achieve negative surgical margins. However, magnetic resonance imaging (MRI), the standard modality for local staging, has limitations when used as a tool for surgical planning. Three-dimensional imagen processing and reconstruction (3-IPR) applied to medical imaging enables precise and interactive visualization of anatomical and tumor structures, facilitating an individualized surgical strategy. This technology allows assessment of tumor infiltration volume, simulation of resections with oncological margins, and customization of the surgical approach. Two representative clinical cases are described in which 3D-IPR provided key information to determine the extent of resection, avoid unnecessary exenterations, or define surgical pathways in tumors involving the lateral compartment. Despite limitations such as cost and processing time, 3D-IPR emerges as a promising tool to enhance surgical precision in LARC. Future applications include artificial intelligence, radiomics, educational simulation, and augmented reality for safer, more precise, and personalized surgery.