Department of Pediatric Surgery, Medical University of Vienna, Vienna, Wien, Austria.
Department of Pediatrics, Medical University of Vienna, Wien, Austria.
Eur J Pediatr Surg. 2022 Apr;32(2):210-214. doi: 10.1055/s-0041-1726424. Epub 2021 Mar 23.
For the classification of the complexity of cloacal malformations and the decision on the operative approach, an exact anatomical assessment is mandatory. To benefit from using three-dimensional (3D)-printed models in preoperative planning and training, the practicability of these models should be guaranteed. The aim of this study was to evaluate the quality and feasibility of a real-size 3D-printed cloaca model for the purpose of cysto-vaginoscopic evaluation.
We performed a 3D reconstruction and printed a real-size, rubber-like 3D model of an infant pelvis with a cloacal malformation and asked invited pediatric surgeons and pediatric urologists to perform a cysto-vaginoscopy on the model and to complete a brief questionnaire to rate the quality and feasibility of the model and to indicate whether they would recommend the model for preoperative planning and training.
Overall, 41 participants rated the model quality as good to very good (M = 3.28, standard deviation [SD] = 0.50, on a scale from 1 to 4). The model was rated as feasible for preoperative training (M = 4.10, SD = 0.75, on a scale from 1 to 5) and most participants (85.4%) would recommend the model for preoperative training. The cysto-vaginoscopy of the model was considered as a valid training tool for real-life cases and improved the confidence on the anatomy of a cloaca.
The results of our study indicate that patient-specific 3D-printed models might be a useful tool in the preoperative evaluation of complex anorectal malformations by simulation of cysto-vaginoscopy with an excellent view on anatomical structures to assess the whole spectrum of the individual cloacal malformation. Our model might be a valuable add-on tool for specialty training in pediatric colorectal surgery.
为了对肛膜闭锁畸形的复杂性进行分类并决定手术方法，必须进行准确的解剖评估。为了从术前规划和培训中受益于使用三维（3D）打印模型，必须保证这些模型的实用性。本研究的目的是评估用于膀胱阴道镜评估的真实大小 3D 打印肛膜模型的质量和可行性。
我们进行了 3D 重建，并打印了一个具有肛膜闭锁畸形的婴儿骨盆的真实大小、橡胶状的 3D 模型，邀请了小儿外科医生和小儿泌尿科医生对模型进行膀胱阴道镜检查，并完成一份简短的问卷，对模型的质量和可行性进行评分，并表示他们是否会推荐该模型用于术前规划和培训。
共有 41 名参与者对模型质量的评价为良好到非常好（M=3.28，标准差 [SD]=0.50，评分为 1 到 4）。该模型被认为可用于术前培训（M=4.10，SD=0.75，评分为 1 到 5），大多数参与者（85.4%）会推荐该模型用于术前培训。模型的膀胱阴道镜检查被认为是真实病例模拟训练的有效工具，并提高了对肛膜解剖结构的信心。
我们的研究结果表明，患者特异性 3D 打印模型可能是通过模拟膀胱阴道镜检查对复杂肛门直肠畸形进行术前评估的有用工具，可极好地观察解剖结构，评估个体肛膜畸形的全貌。我们的模型可能是小儿结直肠外科专业培训的有价值的附加工具。
