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1.
Sci Rep ; 10(1): 11660, 2020 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-32669641

RESUMO

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.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Colo/cirurgia , Neoplasias Colorretais/diagnóstico por imagem , Artéria Mesentérica Superior/diagnóstico por imagem , Veias Mesentéricas/diagnóstico por imagem , Impressão Tridimensional/instrumentação , Idoso , Idoso de 80 Anos ou mais , Colo/irrigação sanguínea , Colo/diagnóstico por imagem , Colo/patologia , Neoplasias Colorretais/irrigação sanguínea , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Angiografia por Tomografia Computadorizada/economia , Angiografia por Tomografia Computadorizada/métodos , Feminino , Humanos , Imageamento Tridimensional/economia , Imageamento Tridimensional/instrumentação , Imageamento Tridimensional/métodos , Laparoscopia/métodos , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , Excisão de Linfonodo/métodos , Linfonodos/irrigação sanguínea , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Linfonodos/cirurgia , Masculino , Artéria Mesentérica Superior/cirurgia , Veias Mesentéricas/cirurgia , Mesentério/irrigação sanguínea , Mesentério/diagnóstico por imagem , Mesentério/patologia , Mesentério/cirurgia , Pessoa de Meia-Idade , Duração da Cirurgia , Impressão Tridimensional/economia , Estudos Prospectivos
2.
J Surg Educ ; 77(5): 1279-1284, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32273250

RESUMO

OBJECTIVE: Complex vascular anatomy has always been a difficult point for medical students. Gastrocolic trunk (Henle trunk) has many branches and variations, involving the venous reflux of the stomach, right colon, and pancreas. This study investigated the effects of 3 dimensional (3D) printing technology on medical interns' understanding of Henle trunk's variation, by comparing 2 dimensional (2D) images. SETTING: Henle trunk modes were manufactured using 3D-CT angiography and 3D-printing technology. PARTICIPANTS: Forty-seven interns from 2 medical schools (Nanjing Medical University and Medical College of Nantong University) participated in the study. DESIGN: The interns were divided randomly allocated into 2 groups, where group 1 was the control group with a 2D image of Henle trunk plus surgical video (named 2D image group), and group 2 was the study group with a 3D printed model of Henle trunk plus surgical video (named 3D-printing group). Knowledge of interns on the Henle trunk was compared between 2 groups using a question test before and after the teaching intervention. RESULTS: All interns had an improved overall assessment score as a result of attending the seminar, whether in the 2D image group or the 3D-printing group. The score of the 2D image group increased 32.57 ± 13.86, and the 3D-printing group increased 47.04 ± 12.99, showing significant difference (p = 0.001). There was no significant difference observed between postseminar scores between 2 medical schools (p = 0.975). There was a significant improvement in satisfaction among the 3D-printing group for education depth, novel and inspiring of teaching method, except for the interaction between teacher and interns (p = 0.215). Interns hope to have more teaching time for 3D printing, and not satisfied with the time of 3D printing teaching compared with those in the 2D image group (p = 0.021). CONCLUSIONS: The 3-D printed Henle trunk model is a very effective teaching tool, which can help interns understand the anatomy of Henle trunk. The application of 3D printing technology in the teaching of interns of complex vascular anatomy is worth popularizing in teaching hospitals.


Assuntos
Anatomia , Estudantes de Medicina , Humanos , Modelos Anatômicos , Pâncreas , Impressão Tridimensional
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