Abstract:

Objective To preliminary explore the clinical value of three⁃dimensional visualization technol⁃ ogy for the laparoscopic D3 radical resection of colorectal cancer. Methods The clinical data of forty patients with colorectal cancer undergoing laparoscopic D3 radical operation in Dongguan Municipal People′s Hospital from May 2019 to December March 2021 were analyzed retrospectively. Before the operation，all patients underwent enhanced CT examination and then used commercial reconstruction software to perform 3D visualization reconstruction and guide the actual operation. Results The three⁃dimensional visualization model clearly showed the shape and direction of the colon，the location of the tumor，the anatomy and variation of the main blood vessels and the blood vessels supplying the cancer，and showing a coincidence rate of 100% with the actual surgical exploration. The D3 radical resection of colorectal cancer is formulated based on the three⁃dimensional model before the operation. The coincidence rate with the actual surgical plan was 100%. All the 40 patients completed operations successfully， and no patient was converted to open surgery. The unexpected injury of blood vessel did not happen. The mean operative time was（162.1 ± 51.7）min with a mean estimated blood loss of（58.6 ± 46.3）mL. The mean time of first flatus was（51.7 ± 36.7）h and the postoperative hospital stay was（8.2 ± 6.5）d. The postoperative complications appeared in 4 patients，including one of inflammatory bowel obstruction，one of anastomotic leakage and two of lymphatic fistula，the complication rate was 10.0% ，and they were all cured with conservative treatments. The mean number of harvested lymph node was（28.8 ± 39.1），among which（3.9 ± 2.5）was positive. TNM staging：Stage Ⅰ4 cases，Stage Ⅱa 8 cases，Stage Ⅱb 5 cases，Stage Ⅲa 15 cases，Stage Ⅲb 5 cases，Stage Ⅲc 3 cases. Conclusions On the basis of clarifying tumor blood supply arteries and their vascular variations，3D visualization technology can not only improve the efficiency and safety of surgery，but also perform accurate laparoscopic D3 radical resection of colorectal cancer on the basis of oncology.

Key words:

three?dimensional visualization technology, laparoscopic, colorectal cancer, D3 radical resection ,