外科理论与实践

外科理论与实践 >

2025 , Vol. 30 >Issue 01: 74 - 78

DOI: https://doi.org/10.16139/j.1007-9610.2025.01.14

综述

三维建模技术在直肠癌手术中的应用与展望

  • 陈子龙 综述 ,
  • 赵任 审校
展开
  • 上海交通大学医学院附属瑞金医院普外科，上海 200025

收稿日期: 2024-01-25

  网络出版日期: 2025-04-25

收起

Application and prospects of three-dimensional modelling technology in rectal cancer surgery

  • CHEN Zilong ,
  • ZHAO Ren
Expand
  • Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2024-01-25

  Online published: 2025-04-25

Fold

摘要

手术是直肠癌根治的主要手段，直肠癌手术目前面临的主要挑战是盆腔解剖结构复杂、手术区域狭窄。三维建模技术将二维的医学影像转化为三维模型，使得医学影像更直观，也更接近手术过程中真实的复杂环境。三维建模技术可重建出病灶及其周围器官、血管、神经等结构，从而帮助疾病的诊疗。目前三维建模技术已经在骨科、泌尿外科、胸外科等外科的术前规划、术中导航、医学教学等领域中发挥重大作用。该技术在直肠癌手术中的应用仍处于探索阶段。本文就三维建模技术在直肠癌手术中应用的相关研究进展进行了综述，以期为该技术在结肠直肠外科的应用研究提供参考。

关键词： 直肠癌; 三维建模; 手术导航; 三维打印; 增强现实

本文引用格式

陈子龙 综述 , 赵任 审校 . 三维建模技术在直肠癌手术中的应用与展望[J]. 外科理论与实践, 2025 , 30(01) : 74 -78 . DOI: 10.16139/j.1007-9610.2025.01.14

Abstract

Surgery is the mainly treatment for rectal cancer. Rectal cancer surgery currently poses specific challenges due to the complex anatomy of pelvic and narrow operating area. Three-dimensional(3D) modelling transforms two-dimensional images into three-dimensional models, makes medical imaging more intuitive and closer to the real surgical procedure. 3D modelling can reconstruct lesions along with surrounding structures, such as organs, vessels, and nerves, thereby enhancing disease diagnosis and treatment. Currently, 3D modelling technology has played a significant role in preoperative planning, intraoperative navigation, medical education, and other fields in orthopedics, urology, thoracic surgery and other surgery. However, its application in rectal surgery is still in the exploratory stage. This article provided a review of the relevant research and progress of 3D modelling in rectal cancer surgery, to improve the development of this technology.

Key words： Rectal cancer; Three-dimensional(3D) modelling; Surgical navigation; Three-dimensional(3D) printing; Augmented reality

参考文献

[1] SUNG H, FERLAY J, SIEGEL R L, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3):209-249.
[2] HAN B, ZHENG R, ZENG H, et al. Cancer incidence and mortality in China, 2022[J]. J Natl Cancer Cent, 2024, 4(1):47-53.
[3] BONJER H J, DEIJEN C L, ABIS G A, et al. A rando-mized trial of laparoscopic versus open surgery for rectal cancer[J]. N Engl J Med, 2015, 372(14):1324-1332.
[4] JEONG S Y, PARK J W, NAM B H, et al. Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): survival outcomes of an open-label, non-inferiority, randomised controlled trial[J]. Lancet Oncol, 2014, 15(7):767-774.
[5] SHIRK J D, THIEL D D, WALLEN E M, et al. Effect of 3-dimensional virtual reality models for surgical planning of robotic-assisted partial nephrectomy on surgical outcomes: a randomized clinical trial[J]. JAMA Netw Open, 2019, 2(9):e1911598.
[6] SAHNAN K, ADEGBOLA S O, TOZER P J, et al. Improving the understanding of perianal crohn fistula through 3D modeling[J]. Ann Surg, 2018, 267(6):e105-e107.
[7] SHEN S, WANG P, LI X, et al. Pre-operative simulation using a three-dimensional printing model for surgical treatment of old and complex tibial plateau fractures[J]. Sci Rep, 2020, 10(1):6044.
[8] SAHNAN K, PELLINO G, ADEGBOLA S O, et al. Deve-lopment of a model of three-dimensional imaging for the preoperative planning of TaTME[J]. Tech Coloproctol, 2018, 22(1):59-63.
[9] HOJO D, MURONO K, NOZAWA H, et al. Utility of a three-dimensional printed pelvic model for lateral pelvic lymph node dissection[J]. Int J Colorectal Dis, 2020, 35(5):905-910.
[10] NAKAO T, SHIMADA M, YOSHIKAWA K, et al. Visua-lization of the pelvic nerves using magnetic resonance imaging for rectal cancer surgery[J]. Surg Endosc, 2023, 37(6):4315-4320.
[11] KONTOVOUNISIOS C, TEKKIS P, BELLO F. 3D ima-ging and printing in pelvic colorectal cancer: 'The New Kid on the Block'[J]. Tech Coloproctol, 2019, 23(2):171-173.
[12] HAMABE A, ITO M. A three-dimensional pelvic model made with a three-dimensional printer: applications for laparoscopic surgery to treat rectal cancer[J]. Tech Coloproctol, 2017, 21(5):383-387.
[13] HONG J S, BROWN K G M, WALLER J, et al. The role of MRI pelvimetry in predicting technical difficulty and outcomes of open and minimally invasive total mesorectal excision: a systematic review[J]. Tech Coloproctol, 2020, 24(10):991-1000.
[14] ESCAL L, NOUGARET S, GUIU B, et al. MRI-based score to predict surgical difficulty in patients with rectal cancer[J]. Br J Surg, 2018, 105(1):140-146.
[15] NAGAI Y, KAWAI K, NOZAWA H, et al. Three-dimensional visualization of the total mesorectal excision plane for dissection in rectal cancer surgery and its ability to predict surgical difficulty[J]. Sci Rep, 2023, 13(1):2130.
[16] PRZEDLACKA A, COX S, TEKKIS P, et al. Rectal 3D MRI modelling for benign and malignant disease[J]. Br J Surg, 2020, 107(11):e561-e562.
[17] HOJO D, EMOTO S, KAWAI K, et al. Potential usefulness of three-dimensional navigation tools for the resection of intra-abdominal recurrence of colorectal cancer[J]. J Gastrointest Surg, 2020, 24(7):1682-1685.
[18] BROWN G, DANIELS I R. Preoperative staging of rectal cancer: the MERCURY research project[J]. Recent Results Cancer Res, 2005,165:58-74.
[19] TAYLOR F G, QUIRKE P, HEALD R J, et al. Preoperative magnetic resonance imaging assessment of circumfe-rential resection margin predicts disease-free survival and local recurrence: 5-year follow-up results of the MERCURY study[J]. J Clin Oncol, 2014, 32(1):34-43.
[20] GARCIA-GRANERO A, PELLINO G, GINER F, et al. A video demonstration of three-dimensional imaging to assess the circumferential resection margin in locally advanced rectal cancer and recurrent rectal cancer - a video vignette[J]. Colorectal Dis, 2020, 22(12):2340-2341.
[21] GARCIA-GRANERO A, PELLINO G, GINER F, et al. A mathematical 3D-method applied to MRI to evaluate prostatic infiltration in advanced rectal cancer[J]. Tech Coloproctol, 2020, 24(6):605-607.
[22] SUEDA T, TEI M, FURUKAWA H, et al. Surgical treatment of rectal cancer with a Retzius shunt: a case report[J]. Surg Case Rep, 2019, 5(1):25.
[23] HORIE H, KOINUMA K, ITO H, et al. Utility of pre-operative 3-D simulation of laparoscopic lateral pelvic lymph node dissection for advanced rectal cancer: surgical outcomes of 10 initial cases[J]. Asian J Endosc Surg, 2018, 11(4):355-361.
[24] YANG S Y, KIM H S, CHO M S, et al. Three-dimensional anatomy of the Denonvilliers' fascia after micro-CT reconstruction[J]. Sci Rep, 2021, 11(1):21759.
[25] YOTSOV T, KARAMANLIEV M, MASLYANKOV S, et al. Mesenteric vascular evaluation with pre-operative multidetector computed tomographic angiography and intraoperative indocyanine green angiography to reduce anastomotic leaks after minimally invasive surgery for colorectal cancer[J]. JSLS, 2022, 26(3):e2022.00022.
[26] TOKUNAGA T, SUGIMOTO M, SAITO Y, et al. Transanal lateral lymph node dissection with intraoperative hologram support in low rectal cancer[J]. Surg Endosc, 2023, 37(7):5414-5420.
[27] RYU S, KITAGAWA T, GOTO K, et al. Intraoperative holographic guidance using virtual reality and mixed rea-lity technology during laparoscopic colorectal cancer surgery[J]. Anticancer Res, 2022, 42(10):4849-4856.
[28] KIM H J, CHOI G S, PARK J S, et al. S122: impact of fluorescence and 3D images to completeness of lateral pelvic node dissection[J]. Surg Endosc, 2020, 34(1):469-476.
[29] MA L, WANG J, KIYOMATSU H, et al. Surgical navigation system for laparoscopic lateral pelvic lymph node dissection in rectal cancer surgery using laparoscopic-vision-tracked ultrasonic imaging[J]. Surg Endosc, 2021, 35(12):6556-6567.
[30] NIJKAMP J, KUHLMANN K F D, IVASHCHENKO O, et al. Prospective study on image-guided navigation surgery for pelvic malignancies[J]. J Surg Oncol, 2019, 119(4):510-517.
[31] VOLONTé F, PUGIN F, BUCHS N C, et al. Console-integrated stereoscopic OsiriX 3D volume-rendered images for da Vinci colorectal robotic surgery[J]. Surg Innov, 2013, 20(2):158-163.
[32] HASSINGER J P, DOZOIS E J, HOLUBAR S D, et al. Virtual pelvic anatomy simulator: a pilot study of usabi-lity and perceived effectiveness[J]. J Surg Res, 2010, 161(1):23-27.
[33] HOJO D, MURONO K, NOZAWA H, et al. Utility of a three-dimensional printed pelvic model for lateral pelvic lymph node dissection education: a randomized controlled trial[J]. J Am Coll Surg, 2019, 229(6):552-559.e3.
[34] BIMURZAYEVA A, KIM M J, AHN J S, et al. Three-dimensional body composition parameters using automatic volumetric segmentation allow accurate prediction of colorectal cancer outcomes[J]. J Cachexia Sarcopenia Muscle, 2024, 15(1):281-291.
Options
文章导航

/

〈 〉