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 mm3, 174 mm2, 154 mm2, 143 mm2, 172 mm2, 345 mm2, 213 mm2, 357 mm2, 173 mm2, 382 mm2, 154 mm2, 227 mm2, 578 cm. The above indicators of No.2 patient were 1 817 224 mm3, 274 mm2, 196 mm2, 487 mm2, 413 mm2, 520 mm2, 254 mm2, 231 mm2, 170 mm2, 212 mm2, 168 mm2, 293 mm2, 620 cm. The above indicators of No.3 patient were 2 183 019 mm3, 320 mm2, 408 mm2, 281 mm2, 222 mm2, 194 mm2, 219 mm2, 188 mm2, 419 mm2, 326 mm2, 235 mm2, 281 mm2, 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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