The impact of three-dimensional reconstruction and standardised CT interpretation (AMIGO) on the anatomical understanding of mesenteric vascular anatomy for planning complete mesocolic excision surgery: A randomised crossover study.


Journal

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611

Informations de publication

Date de publication:
04 2022
Historique:
revised: 30 11 2021
received: 04 08 2021
accepted: 22 12 2021
pubmed: 7 1 2022
medline: 4 5 2022
entrez: 6 1 2022
Statut: ppublish

Résumé

Preoperative planning is a crucial aspect of safe complete mesocolic excision (CME) surgery. 3D models derived from imaging may help improve anatomical understanding of the complex vascular anatomy. Here, we assessed the effect of 3D models on surgeons' anatomical understanding in comparison to a systematic approach for CT scan interpretation (AMIGO). Fifteen cases were included in the study. Two GI radiology consultants reviewed each scan to ascertain the vascular anatomy. Virtual 3D models were produced and displayed on a web-based platform (https://skfb.ly/6OZUZ). A total of 13 surgical trainees were recruited. Candidates were assessed after baseline anatomical training and subsequently using the AMIGO method and 3D models. Five cases were randomly allocated in each round of testing for each participant. The primary outcome measure was an objective vascular anatomy knowledge score. The secondary outcome measure was subjective feedback from participants. Both 3D and AMIGO significantly improved anatomical understanding in comparison to baseline testing. However, 3D was superior to AMIGO (3D [n = 65; median score 8/14] vs. AMIGO [n = 65; median score 6/14; p < 0.0001]. For 13/15 patient cases examined, 3D was superior to the AMIGO method. Eleven participants demonstrated better anatomical understanding using 3D models versus AMIGO. Ten participants preferred 3D models in comparison to standard CT imaging. 3D models improve anatomical understanding of mesenteric vascular anatomy in a group of colorectal surgical trainees in comparison to a formal CT interpretation method. 3D models may be a useful planning adjunct to 2D imaging for CME surgery.

Sections du résumé

BACKGROUND
Preoperative planning is a crucial aspect of safe complete mesocolic excision (CME) surgery. 3D models derived from imaging may help improve anatomical understanding of the complex vascular anatomy. Here, we assessed the effect of 3D models on surgeons' anatomical understanding in comparison to a systematic approach for CT scan interpretation (AMIGO).
METHOD
Fifteen cases were included in the study. Two GI radiology consultants reviewed each scan to ascertain the vascular anatomy. Virtual 3D models were produced and displayed on a web-based platform (https://skfb.ly/6OZUZ). A total of 13 surgical trainees were recruited. Candidates were assessed after baseline anatomical training and subsequently using the AMIGO method and 3D models. Five cases were randomly allocated in each round of testing for each participant. The primary outcome measure was an objective vascular anatomy knowledge score. The secondary outcome measure was subjective feedback from participants.
RESULTS
Both 3D and AMIGO significantly improved anatomical understanding in comparison to baseline testing. However, 3D was superior to AMIGO (3D [n = 65; median score 8/14] vs. AMIGO [n = 65; median score 6/14; p < 0.0001]. For 13/15 patient cases examined, 3D was superior to the AMIGO method. Eleven participants demonstrated better anatomical understanding using 3D models versus AMIGO. Ten participants preferred 3D models in comparison to standard CT imaging.
CONCLUSIONS
3D models improve anatomical understanding of mesenteric vascular anatomy in a group of colorectal surgical trainees in comparison to a formal CT interpretation method. 3D models may be a useful planning adjunct to 2D imaging for CME surgery.

Identifiants

pubmed: 34989089
doi: 10.1111/codi.16041
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

388-400

Informations de copyright

© 2022 The Association of Coloproctology of Great Britain and Ireland.

Références

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Auteurs

Jordan Fletcher (J)

St Mark's Hospital and Academic Institute, Harrow, UK.
Department of Surgery and Cancer, Imperial College London, London, UK.

Rajapandian Ilangovan (R)

St Mark's Hospital and Academic Institute, Harrow, UK.

George Hanna (G)

Department of Surgery and Cancer, Imperial College London, London, UK.

Danilo Miskovic (D)

St Mark's Hospital and Academic Institute, Harrow, UK.
Department of Surgery and Cancer, Imperial College London, London, UK.

Phillip Lung (P)

St Mark's Hospital and Academic Institute, Harrow, UK.
Department of Surgery and Cancer, Imperial College London, London, UK.

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