Your browser doesn't support javascript.
loading
Clinical validation of 3D virtual modelling for laparoscopic complete mesocolic excision with central vascular ligation for proximal colon cancer.
Kearns, Emma C; Moynihan, Alice; Dalli, Jeffrey; Khan, Mohammad Faraz; Singh, Sneha; McDonald, Katherine; O'Reilly, Jessica; Moynagh, Niamh; Myles, Christian; Brannigan, Ann; Mulsow, Jurgen; Shields, Conor; Jones, James; Fenlon, Helen; Lawler, Leo; Cahill, Ronan A.
Afiliación
  • Kearns EC; UCD Centre for Precision Surgery, University College Dublin, Ireland.
  • Moynihan A; UCD Centre for Precision Surgery, University College Dublin, Ireland.
  • Dalli J; UCD Centre for Precision Surgery, University College Dublin, Ireland.
  • Khan MF; UCD Centre for Precision Surgery, University College Dublin, Ireland.
  • Singh S; Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
  • McDonald K; Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
  • O'Reilly J; Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
  • Moynagh N; UCD Centre for Precision Surgery, University College Dublin, Ireland.
  • Myles C; Anatomy, University College Dublin, Ireland.
  • Brannigan A; Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
  • Mulsow J; Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
  • Shields C; Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
  • Jones J; Anatomy, University College Dublin, Ireland.
  • Fenlon H; Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland.
  • Lawler L; Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland.
  • Cahill RA; UCD Centre for Precision Surgery, University College Dublin, Ireland; Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland. Electronic address: ronan.cahill@ucd.ie.
Eur J Surg Oncol ; 50(11): 108597, 2024 Aug 10.
Article en En | MEDLINE | ID: mdl-39173461
ABSTRACT

INTRODUCTION:

Laparoscopic Complete Mesocolic Excision (CME) with Central Vascular Ligation (CVL) in colon cancer surgery has not been broadly adopted in part because of safety concerns. Pre-operative 3-D virtual modelling (3DVM) may help but needs validation.

METHODS:

3DVM were routinely constructed from CT mesenteric angiograms (CTMA) using a commercial service (Visible Patient, Strasbourg, France) for consecutive patients during our CMECVL learning curve over three years. 3DVMs were independently checked versus CTMA and operative findings. CMECVL outcomes were compared versus other patients undergoing standard mesocolic excision (SME) surgery laparoscopically in the same hospital as control. Stakeholders were studied regarding 3DVM use and usefulness (including detail retention) versus CTMA and a physical 3D-printed model.

RESULTS:

26 patients underwent 3DVM with intraoperative display during laparoscopic CMECVL within existing workflows. 3DVM accuracy was 96 % re arteriovenous variations at patient level versus CTMA/intraoperative findings including accessory middle colic artery identification in three patients. Twenty-two laparoscopic CMECVL with 3DVM cases were compared with 49 SME controls (age 69 ± 10 vs 70.9 ± 11 years, 55 % vs 53 % males). There were no intraoperative complications with CMECVL and similar 30-day postoperative morbidity (30 % vs 29 %), hospital stay (9 ± 3 vs 12 ± 13 days), 30-day readmission (6 % vs 4 %) and reoperation (0 % vs 4 %) rates. Intraoperative times were longer (215.7 ± 43.9 vs 156.9 ± 52.9 min, p=<0.01) but decreased significantly over time. 3DVM surveys (n = 98, 20 surgeons, 48 medical students, 30 patients/patient relatives) and comparative study revealed majority endorsement (90 %) and favour (87 %).

CONCLUSION:

3DVM use was positively validated for laparoscopic CMECVL and valued by clinicians, students, and patients alike.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Irlanda Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Irlanda Pais de publicación: Reino Unido