The University of Melbourne, Parkville, VIC, Australia.
Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia.
Tech Coloproctol. 2023 Apr;27(4):257-270. doi: 10.1007/s10151-023-02757-7. Epub 2023 Feb 4.
The aim of this review was to explore the role of three-dimensional (3D) printing in colorectal surgical education and procedural simulation, and to assess the effectiveness of 3D-printed models in anatomic and operative education in colorectal surgery.
A systematic review of the literature was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify relevant publications relating to the use of 3D-printed models in colorectal surgery in an educational context. The search encompassed OVID Medline, Web of Science and EMBASE including papers in English published from 1 January 1995 to 1 January 2023. A total of 1018 publications were screened, and 5 met the criteria for inclusion in this review.
Four distinct 3D models were described across five studies. Two models demonstrated objective benefits in the use of 3D-printed models in anatomical education in academic outcomes at all levels of learner medical experience and were well accepted by learners. One model utilised for preoperative visualisation demonstrated improved operative outcomes in complete mesocolic excision compared with preoperative imaging review, with a 22.1% reduction in operative time (p < 0.001), 9.2% reduction in surgical duration (p = 0.035) and 37.3% reduction in intraoperative bleeding volume amongst novice surgeons (p < 0.01). Technical simulation has been demonstrated in a feasibility context in one model but remains limited in scope and application on account of the characteristics of available printing materials.
3D printing is well accepted and effective for anatomic education and preoperative procedural planning amongst colorectal surgeons, trainees and medical students but remains a technology in the early stages of its possible application. Technological advancements are required to improve the tissue realism of 3D-printed organ models to achieve greater fidelity and provide realistic colorectal surgical simulations.
本综述旨在探讨三维（3D）打印在结直肠外科教育和手术模拟中的作用，并评估 3D 打印模型在结直肠外科解剖和手术教育中的有效性。
按照系统评价和荟萃分析（PRISMA）指南对文献进行系统综述，以确定与结直肠外科教育中使用 3D 打印模型相关的文献。检索涵盖了 OVID Medline、Web of Science 和 EMBASE，包括 1995 年 1 月 1 日至 2023 年 1 月 1 日发表的英文文献。共筛选了 1018 篇文献，其中 5 篇符合本综述的纳入标准。
在五项研究中描述了四种不同的 3D 模型。有两项研究表明，在所有级别的学习者医学经验的解剖学教育中使用 3D 打印模型具有客观的益处，并且受到学习者的欢迎。一项用于术前可视化的模型与术前影像学检查相比，在完全结肠系膜切除术中改善了手术结果，手术时间缩短了 22.1%（p<0.001），手术持续时间缩短了 9.2%（p=0.035），初级外科医生术中出血量减少了 37.3%（p<0.01）。一项研究在可行性背景下展示了技术模拟，但由于可用打印材料的特性，其范围和应用仍然有限。
3D 打印在结直肠外科医生、受训者和医学生中得到了广泛认可，并且在解剖学教育和术前手术规划方面非常有效，但它仍然是一种处于早期应用阶段的技术。需要技术进步来提高 3D 打印器官模型的组织真实感，以实现更高的保真度并提供真实的结直肠手术模拟。
