Skip to main content
Top
Published in: International Journal of Colorectal Disease 5/2020

01-05-2020 | Original Article

Utility of a three-dimensional printed pelvic model for lateral pelvic lymph node dissection

Authors: Daisuke Hojo, Koji Murono, Hiroaki Nozawa, Kazushige Kawai, Keisuke Hata, Toshiaki Tanaka, Soichiro Ishihara

Published in: International Journal of Colorectal Disease | Issue 5/2020

Login to get access

Abstract

Purpose

In patients with advanced lower rectal cancer, the complex pelvic anatomy renders lateral pelvic lymph node dissection to be challenging. Therefore, we evaluated the utility of printing a three-dimensional (3D) pelvic model for lateral pelvic lymph node dissection.

Methods

We included 22 patients who underwent lateral pelvic lymph node dissection for rectal cancer between June 2017 and February 2019. Using CT scans, 3D pelvic images and models were constructed and printed, respectively. Thirty colorectal surgeons subjectively evaluated the utility of 3D pelvic models based on a 5-point Likert scale questionnaire (1 = strongly disagree, 5 = strongly agree).

Results

The average Likert score for the question “Would a 3D model be useful for understanding pelvic anatomy?” was 4.68. Cases with clinically diagnosed metastatic lymph nodes (4.79 ± 0.44) scored higher than those without them (4.38 ± 0.77, p = 0.02). For spatial comprehension of pelvic anatomy, 3D models scored higher (4.83) than 3D images (4.36, p < 0.001). The ease of use of 3D models and images was scored 4.60 and 4.20, respectively (p = 0.015). With experience, the 3D image reconstruction time decreased from 900 to 150 min.

Conclusion

The 3D pelvic models may be helpful for experienced surgeons to understand the pelvic anatomy in lateral pelvic lymph node dissection.
Appendix
Available only for authorised users
Literature
1.
go back to reference Watanabe T, Muro K, Ajioka Y, Hashiguchi Y, Ito Y, Saito Y, Hamaguchi T, Ishida H, Ishiguro M, Ishihara S, Kanemitsu Y, Kawano H, Kinugasa Y, Kokudo N, Murofushi K, Nakajima T, Oka S, Sakai Y, Tsuji A, Uehara K, Ueno H, Yamazaki K, Yoshida M, Yoshino T, Boku N, Fujimori T, Itabashi M, Koinuma N, Morita T, Nishimura G, Sakata Y, Shimada Y, Takahashi K, Tanaka S, Tsuruta O, Yamaguchi T, Yamaguchi N, Tanaka T, Kotake K, Sugihara K, Japanese Society for Cancer of the Colon and Rectum (2018) Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer. Int J Clin Oncol 23:1–34CrossRef Watanabe T, Muro K, Ajioka Y, Hashiguchi Y, Ito Y, Saito Y, Hamaguchi T, Ishida H, Ishiguro M, Ishihara S, Kanemitsu Y, Kawano H, Kinugasa Y, Kokudo N, Murofushi K, Nakajima T, Oka S, Sakai Y, Tsuji A, Uehara K, Ueno H, Yamazaki K, Yoshida M, Yoshino T, Boku N, Fujimori T, Itabashi M, Koinuma N, Morita T, Nishimura G, Sakata Y, Shimada Y, Takahashi K, Tanaka S, Tsuruta O, Yamaguchi T, Yamaguchi N, Tanaka T, Kotake K, Sugihara K, Japanese Society for Cancer of the Colon and Rectum (2018) Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer. Int J Clin Oncol 23:1–34CrossRef
2.
go back to reference Watanabe T, Hata K (2016) Robotic surgery for rectal cancer with lateral lymph node dissection. Br J Surg 103:1755–1757CrossRef Watanabe T, Hata K (2016) Robotic surgery for rectal cancer with lateral lymph node dissection. Br J Surg 103:1755–1757CrossRef
3.
go back to reference Hojo K, Koyama Y (1982) Postoperative follow-up studies on cancer of the colon and rectum. Am J Surg 143:293–295CrossRef Hojo K, Koyama Y (1982) Postoperative follow-up studies on cancer of the colon and rectum. Am J Surg 143:293–295CrossRef
4.
go back to reference Georgiou P, Tan E, Gouvas N et al (2009) Extended lymphadenectomy versus conventional surgery for rectal cancer: a meta-analysis. Lancet Oncol 10:1053–1062CrossRef Georgiou P, Tan E, Gouvas N et al (2009) Extended lymphadenectomy versus conventional surgery for rectal cancer: a meta-analysis. Lancet Oncol 10:1053–1062CrossRef
5.
go back to reference Yamaguchi T, Konishi T, Kinugasa Y et al (2017) Laparoscopic versus open lateral lymph node dissection for locally advanced low rectal cancer: a subgroup analysis of a large multicenter cohort study in Japan. Dis Colon Rectum 60:954–964CrossRef Yamaguchi T, Konishi T, Kinugasa Y et al (2017) Laparoscopic versus open lateral lymph node dissection for locally advanced low rectal cancer: a subgroup analysis of a large multicenter cohort study in Japan. Dis Colon Rectum 60:954–964CrossRef
6.
go back to reference Yamaguchi T, Kinugasa Y, Shiomi A et al (2018) Oncological outcomes of robotic-assisted laparoscopic versus open lateral lymph node dissection for locally advanced low rectal cancer. Surg Endosc 32:4498–4505CrossRef Yamaguchi T, Kinugasa Y, Shiomi A et al (2018) Oncological outcomes of robotic-assisted laparoscopic versus open lateral lymph node dissection for locally advanced low rectal cancer. Surg Endosc 32:4498–4505CrossRef
7.
go back to reference Zelhart M, Kaiser AM (2018) Robotic versus laparoscopic versus open colorectal surgery: towards defining criteria to the right choice. Surg Endosc 32:24–38CrossRef Zelhart M, Kaiser AM (2018) Robotic versus laparoscopic versus open colorectal surgery: towards defining criteria to the right choice. Surg Endosc 32:24–38CrossRef
8.
go back to reference Nakayama K, Oshiro Y, Miyamoto R et al (2017) The effect of three-dimensional preoperative simulation on liver surgery. World J Surg 41:1840–1847CrossRef Nakayama K, Oshiro Y, Miyamoto R et al (2017) The effect of three-dimensional preoperative simulation on liver surgery. World J Surg 41:1840–1847CrossRef
9.
go back to reference Miyamoto R, Oshiro Y, Sano N et al (2018) Three-dimensional surgical simulation of the bile duct and vascular arrangement in pancreatoduodenectomy: a retrospective cohort study. Ann Med Surg (Lond) 36:17–22CrossRef Miyamoto R, Oshiro Y, Sano N et al (2018) Three-dimensional surgical simulation of the bile duct and vascular arrangement in pancreatoduodenectomy: a retrospective cohort study. Ann Med Surg (Lond) 36:17–22CrossRef
10.
go back to reference Oshiro Y, Mitani J, Okada T, Ohkohchi N (2017) A novel three-dimensional print of liver vessels and tumors in hepatectomy. Surg Today 47:521–524CrossRef Oshiro Y, Mitani J, Okada T, Ohkohchi N (2017) A novel three-dimensional print of liver vessels and tumors in hepatectomy. Surg Today 47:521–524CrossRef
11.
go back to reference Zein NN, Hanouneh IA, Bishop PD et al (2013) Three-dimensional print of a liver for preoperative planning in living donor liver transplantation. Liver Transpl 19:1304–1310CrossRef Zein NN, Hanouneh IA, Bishop PD et al (2013) Three-dimensional print of a liver for preoperative planning in living donor liver transplantation. Liver Transpl 19:1304–1310CrossRef
12.
go back to reference Komai Y, Sugimoto M, Gotohda N, Matsubara N, Kobayashi T, Sakai Y, Shiga Y, Saito N (2016) Patient-specific 3-dimensional printed kidney designed for "4D" surgical navigation: a novel aid to facilitate minimally invasive off-clamp partial nephrectomy in complex tumor cases. Urology 91:226–233CrossRef Komai Y, Sugimoto M, Gotohda N, Matsubara N, Kobayashi T, Sakai Y, Shiga Y, Saito N (2016) Patient-specific 3-dimensional printed kidney designed for "4D" surgical navigation: a novel aid to facilitate minimally invasive off-clamp partial nephrectomy in complex tumor cases. Urology 91:226–233CrossRef
13.
go back to reference Chandak P, Byrne N, Coleman A et al (2019) Patient-specific 3D printing: a novel technique for complex pediatric renal transplantation. Ann Surg 269:e18–e23CrossRef Chandak P, Byrne N, Coleman A et al (2019) Patient-specific 3D printing: a novel technique for complex pediatric renal transplantation. Ann Surg 269:e18–e23CrossRef
14.
go back to reference Marconi S, Pugliese L, Botti M et al (2017) Value of 3D printing for the comprehension of surgical anatomy. Surg Endosc 31:4102–4110CrossRef Marconi S, Pugliese L, Botti M et al (2017) Value of 3D printing for the comprehension of surgical anatomy. Surg Endosc 31:4102–4110CrossRef
15.
go back to reference Buia A, Stockhausen F, Filmann N, Hanisch E (2017) 2D vs. 3D imaging in laparoscopic surgery—results of a prospective randomized trial. Langenbeck's Arch Surg 402:1241–1253CrossRef Buia A, Stockhausen F, Filmann N, Hanisch E (2017) 2D vs. 3D imaging in laparoscopic surgery—results of a prospective randomized trial. Langenbeck's Arch Surg 402:1241–1253CrossRef
16.
go back to reference Pietrabissa A, Marconi S, Peri A et al (2016) From CT scanning to 3-D printing technology for the preoperative planning in laparoscopic splenectomy. Surg Endosc 30:366–371CrossRef Pietrabissa A, Marconi S, Peri A et al (2016) From CT scanning to 3-D printing technology for the preoperative planning in laparoscopic splenectomy. Surg Endosc 30:366–371CrossRef
17.
go back to reference Fasel JH, Aguiar D, Kiss-Bodolay D et al (2016) Adapting anatomy teaching to surgical trends: a combination of classical dissection, medical imaging, and 3D-printing technologies. Surg Radiol Anat 38:361–367CrossRef Fasel JH, Aguiar D, Kiss-Bodolay D et al (2016) Adapting anatomy teaching to surgical trends: a combination of classical dissection, medical imaging, and 3D-printing technologies. Surg Radiol Anat 38:361–367CrossRef
18.
go back to reference Chen S, Pan Z, Wu Y et al (2017) The role of three-dimensional printed models of skull in anatomy education: a randomized controlled trail. Sci Rep 7:575CrossRef Chen S, Pan Z, Wu Y et al (2017) The role of three-dimensional printed models of skull in anatomy education: a randomized controlled trail. Sci Rep 7:575CrossRef
19.
go back to reference Buntaro A (1928) Das Arteriensystem der Japaner. Kaiserlich-japanische Universität zu Kyoto, Kyoto Buntaro A (1928) Das Arteriensystem der Japaner. Kaiserlich-japanische Universität zu Kyoto, Kyoto
20.
go back to reference Ishihara S, Kawai K, Tanaka T et al (2017) Oncological outcomes of lateral pelvic lymph node metastasis in rectal cancer treated with preoperative chemoradiotherapy. Dis Colon Rectum 60:469–476CrossRef Ishihara S, Kawai K, Tanaka T et al (2017) Oncological outcomes of lateral pelvic lymph node metastasis in rectal cancer treated with preoperative chemoradiotherapy. Dis Colon Rectum 60:469–476CrossRef
21.
go back to reference Kusters M, Slater A, Muirhead R, Hompes R, Guy RJ, Jones OM, George BD, Lindsey I, Mortensen NJ, Cunningham C (2017) What to do with lateral nodal disease in low locally advanced rectal cancer? A call for further reflection and research. Dis Colon Rectum 60:577–585CrossRef Kusters M, Slater A, Muirhead R, Hompes R, Guy RJ, Jones OM, George BD, Lindsey I, Mortensen NJ, Cunningham C (2017) What to do with lateral nodal disease in low locally advanced rectal cancer? A call for further reflection and research. Dis Colon Rectum 60:577–585CrossRef
22.
go back to reference Ogura A, Konishi T, Cunningham C et al (2019) Neoadjuvant (chemo)radiotherapy with total mesorectal excision only is not sufficient to prevent lateral local recurrence in enlarged nodes: results of the multicenter lateral node study of patients with low cT3/4 rectal cancer. J Clin Oncol 37:33–43CrossRef Ogura A, Konishi T, Cunningham C et al (2019) Neoadjuvant (chemo)radiotherapy with total mesorectal excision only is not sufficient to prevent lateral local recurrence in enlarged nodes: results of the multicenter lateral node study of patients with low cT3/4 rectal cancer. J Clin Oncol 37:33–43CrossRef
23.
go back to reference Malakorn S, Ouchi A, Sammour T et al (2018) Robotic lateral pelvic lymph node dissection after neoadjuvant chemoradiation: view from the West. Dis Colon Rectum 61:1119–1120CrossRef Malakorn S, Ouchi A, Sammour T et al (2018) Robotic lateral pelvic lymph node dissection after neoadjuvant chemoradiation: view from the West. Dis Colon Rectum 61:1119–1120CrossRef
24.
go back to reference Ishihara S, Kawai K, Tanaka T et al (2018) Diagnostic value of FDG-PET/CT for lateral pelvic lymph node metastasis in rectal cancer treated with preoperative chemoradiotherapy. Tech Coloproctol 22:347–354CrossRef Ishihara S, Kawai K, Tanaka T et al (2018) Diagnostic value of FDG-PET/CT for lateral pelvic lymph node metastasis in rectal cancer treated with preoperative chemoradiotherapy. Tech Coloproctol 22:347–354CrossRef
25.
go back to reference Hamabe A, Ito M (2017) A three-dimensional pelvic model made with a three-dimensional printer: applications for laparoscopic surgery to treat rectal cancer. Tech Coloproctol 21:383–387CrossRef Hamabe A, Ito M (2017) A three-dimensional pelvic model made with a three-dimensional printer: applications for laparoscopic surgery to treat rectal cancer. Tech Coloproctol 21:383–387CrossRef
Metadata
Title
Utility of a three-dimensional printed pelvic model for lateral pelvic lymph node dissection
Authors
Daisuke Hojo
Koji Murono
Hiroaki Nozawa
Kazushige Kawai
Keisuke Hata
Toshiaki Tanaka
Soichiro Ishihara
Publication date
01-05-2020
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 5/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-020-03534-w

Other articles of this Issue 5/2020

International Journal of Colorectal Disease 5/2020 Go to the issue