3d reconstruction and modeling after gastrectomy with jejunogastroplasty for acute bleeding gastric cancer
DOI:
https://doi.org/10.11603/2414-4533.2021.3.12533Keywords:
gastric cancer, gastrectomy, jejunogastroplasty, 3D reconstructionAbstract
The aim of the work: to determine the role of 3D reconstruction and modeling in the diagnosis of postoperative conditions after total gastrectomy (GE) for acute bleeding gastric cancer (ABGC).
Materials and Methods. The analysis included 268 patients after GE, 165 of them had acute gastrointestinal bleeding. In 39 patients, total GE was performed in combination with JGP for ABGC. The method has been developed for one-stage reconstructive JGP after total GE by hand suturing (3) of a loop of the small intestine in the form of the letter F ("triple anastomosis"), and three methods of hardware (36) JGP after total GE for ABGC using circular and linear staplers.
CT – modeling with 3D reconstruction was performed in three patients who underwent GE with JGP (artificial stomach) with the inclusion of the duodenum. The visualization and location of the artificial small intestinal reservoir was determined by creating its volumetric model, taking into account the spatial location of the great vessels and nerves, followed by printing the model on a 3D printer. To create an individual mock-up prototype (model), the FDM (Fused Deposition Modeling) technology is applied – modeling by the fused deposition method.
Results and Discussion. The research results have shown that it is desirable to supplement the total GE for ABGC in young and middle-aged patients with simultaneous JGP with the inclusion of the duodenum. After a total GE for ABGC with the development of pathological syndromes, it is advisable to use a two-stage reconstructive JGP with the creation of an artificial small bowel reservoir by a hardware method with the inclusion of a duodenum, which improves the quality of life of patients in the long-term postoperative period.
3D reconstruction and modeling after GE with JGP for ABGC allows to estimate the volume, syntopias and skeletotopy of the artificial small bowel reservoir, is essential in the diagnosis of postoperative conditions and pathological syndromes, and allows predicting the course of the postoperative period and the functional results of GE with JGP .
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