Inflammatory bowel diseases · 2023
Preoperative Simulation of Ileal Pouch-Anal Anastomosis in Patients With Ulcerative Colitis Using a 3-Dimensional Printed Model.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Yokose Shota, Murono Koji, Nozawa Hiroaki, Sasaki Kazuhito, Emoto Shigenobu, Matsuzaki Hiroyuki, Yokoyama Yuichiro, Abe Shinya, Nagai Yuzo, Yoshioka Yuichiro, Shinagawa Takahide, Sonoda Hirofumi, Murai Shin, Komatsu Koichi, Ishihara Soichiro
Аннотация
BACKGROUND: During restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis-associated colorectal cancer or dysplasia, ileal pouch-anal handsewn anastomosis (IAA) is preferred to avoid the risk of cancer development in the remaining rectal mucosa. However, there is a risk of the ileal pouch not reaching the anus with this procedure. Here, we created deformable 3-dimensional (3D) models for simulation.
METHOD: Six patients who underwent IAA without vessel ligation and 5 patients who underwent ileal pouch-anal canal double-stapled anastomosis (IACA) because the ileal pouch did not reach the anus were studied. A 3D printer was used to create deformable 3D models from the data obtained from computed tomography scans. The positional relationship among the mesenteric arteries, pubis, and coccyx were evaluated.
RESULT: The distance between the superior mesenteric artery root and the tip of the ileal artery was longer in the IAA group than that in the IACA group (IAA vs IACA: 26.2 ± 2.1 cm vs 20.9 ± 1.6cm). The distance from the tip of the ileal artery to the coccyx (IAA vs IACA: 6.7 ± 1.7 cm vs 12.1 ± 2.1 cm) and the distance from the tip of the ileal artery to the lower edge of the pubis (IAA vs IACA; 8.1 ± 1.3 cm vs 12.7 ± 2.4 cm) were longer in the IACA group than those in the IAA group.
CONCLUSIONS: We established a method for creating 3D deformable models of patients with ileal pouch-anal anastomosis. These 3D models may be useful for preoperative simulation.
METHOD: Six patients who underwent IAA without vessel ligation and 5 patients who underwent ileal pouch-anal canal double-stapled anastomosis (IACA) because the ileal pouch did not reach the anus were studied. A 3D printer was used to create deformable 3D models from the data obtained from computed tomography scans. The positional relationship among the mesenteric arteries, pubis, and coccyx were evaluated.
RESULT: The distance between the superior mesenteric artery root and the tip of the ileal artery was longer in the IAA group than that in the IACA group (IAA vs IACA: 26.2 ± 2.1 cm vs 20.9 ± 1.6cm). The distance from the tip of the ileal artery to the coccyx (IAA vs IACA: 6.7 ± 1.7 cm vs 12.1 ± 2.1 cm) and the distance from the tip of the ileal artery to the lower edge of the pubis (IAA vs IACA; 8.1 ± 1.3 cm vs 12.7 ± 2.4 cm) were longer in the IACA group than those in the IAA group.
CONCLUSIONS: We established a method for creating 3D deformable models of patients with ileal pouch-anal anastomosis. These 3D models may be useful for preoperative simulation.