Department of General Surgery, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, 68 Zhongshan Road, Wuxi, 214002, Jiangsu, People's Republic of China.
Department of Radiology, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, 214002, People's Republic of China.
Sci Rep. 2020 Jul 15;10(1):11660. doi: 10.1038/s41598-020-68578-y.
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.
肠系膜血管解剖结构复杂，对右半结直肠手术非常重要。三维（3D）打印这些血管在右半结肠癌手术中的应用鲜有报道。在这项前瞻性临床研究中，61 例接受腹腔镜右半结肠癌手术的患者术前随机分为 3 组：3D 打印组（20 例）、3D 图像组（19 例）和对照组（22 例）。手术时间、出血量和淋巴结清扫数量设计为主要终点，而术后并发症、术后排气恢复时间、住院时间、患者满意度和医疗费用设计为次要终点。为了减少纳入不同外科医生对研究的影响，根据手术经验将手术团队分为 2 组。3D 打印组和 3D 图像组的手术时间明显缩短（138.4 ± 19.5 和 154.7 ± 25.9 min 比 177.6 ± 24.4 min，P = 0.000 和 P = 0.006），而这两组的淋巴结清扫数量明显增加（19.1 ± 3.8 和 17.6 ± 3.9 比 15.8 ± 3.0，P = 0.001 和 P = 0.024）。同时，与对照组相比，3D 打印组的出血量明显减少（75.8 ± 30.4 mL 比 120.9 ± 39.1 mL，P = 0.000）。此外，与 3D 图像组和对照组相比，3D 打印组患者对有效沟通的满意度更高。使用 3D 打印技术后，医疗费用降低了 6.74%。我们的结果表明，3D 打印技术可以缩短手术时间和总出血量，增加淋巴结清扫数量。3D 打印技术可能对新手外科医生更有帮助。
中国临床试验注册中心，ChiCTR1800017161。注册于 2018 年 7 月 15 日。
