Abstract:
Objective:To construct a computed tomography (CT)-based three-dimensional digital model of small bowel, and investigate its application value for predication of small bowel length before bariatric surgery.
Methods:The retrospective and descriptive study was conducted. The clinical data of 3 patients with obesity who were admitted to the Daping Hospital of Army Medical University from December 2018 to January 2019 were collected. There were 2 males and 1 female, aged from from 24 to 44 years, with a median age of 25 years. Patients underwent abdominal enhanced CT examination before operation, and the three-dimensional digital models of small bowel for each patient were constructed respectively. Of the 3 patients, 2 underwent sleeve gastrectomy and 1 underwent Roux-en-Y gastric bypass. The 3 patients were numbered as No.1, No.2, and No.3 according to the operation time. Observation indicators: (1) construction of three-dimensional digital model of small bowel and preoperative prediction of small bowel length; (2) intraoperative measurement of small bowel length and the relative error between preoperative prediction of small bowel length and intraoperative measurement of small bowel length. Count data were represented as absolute numbers or percentages.
Results:(1) Construction of three-dimensional digital model of small bowel and preoperative prediction of small bowel length: the three-dimensional digital models of small bowel for each patient were constructed respectively before operation. The volume of small bowel, area of each cross-section for the 10 cross-sections of small bowel, average area of cross-section of small bowel, preoperative prediction of small bowel length in the three-dimensional digital model of small bowel of No.1 patient were 1 312 985 mm
3, 174 mm
2, 154 mm
2, 143 mm
2, 172 mm
2, 345 mm
2, 213 mm
2, 357 mm
2, 173 mm
2, 382 mm
2, 154 mm
2, 227 mm
2, 578 cm. The above indicators of No.2 patient were 1 817 224 mm
3, 274 mm
2, 196 mm
2, 487 mm
2, 413 mm
2, 520 mm
2, 254 mm
2, 231 mm
2, 170 mm
2, 212 mm
2, 168 mm
2, 293 mm
2, 620 cm. The above indicators of No.3 patient were 2 183 019 mm
3, 320 mm
2, 408 mm
2, 281 mm
2, 222 mm
2, 194 mm
2, 219 mm
2, 188 mm
2, 419 mm
2, 326 mm
2, 235 mm
2, 281 mm
2, 777 cm. (2) Intraoperative measurement of small bowel length and the relative error between preoperative prediction of small bowel length and intraoperative measurement of small bowel length: the length of small bowel measured intraoperatively for No.1, No.2, and No.3 patients were 570 cm, 600 cm, and 780 cm, respectively. The relative error between preoperative prediction of small bowel length and intraoperative measurement of small bowel length of No.1, No.2, and No.3 patients were 1.40%、3.33%、0.38%, respectively.
Conclusion:Three-dimensional digital model of the small bowel can predict the small bowel length before bariatric surgery.
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