Preliminary Study Of Male Pelvic Digital 3D Reconstruction Model And Application Of Bladder In Laparoscopic Radical Cystectomy

Background and objectiveBladder cancer is one of the most common tumors in the urinary system with the main pathology type including urothelial carcinoma?squamous cell carcinoma?adenocarcinoma,grounded into muscle invasive and non-muscle-invasive bladder cancer by TNM staging generally.According to gender statistics analysis,the incidence of bladder cancer for males is 3.3 times comparing to the females.Radical cystectomy has become the gold standard procedure for muscle invasive and high risk non-muscle-invasive bladder cancer,including radical cystectomy and pelvic lymph node dissection.The management for vascular of bladder and protecting the pelvic organs are the key point in this operation.Enhanced computer tomography is the major method for diagnosis and preoperative planning,but enhanced CT?CTU are difficult to demonstrating the whole view and relationship for the bladder and the significant structure of pelvic.Digital 3D technology has been widiey used in clinical medicine.However,the report about the application of digital 3D reconstruction in radical cystectomy is rare.Construct in vivo male pelvic digitalized 3D model of bladder for using in laparoscopic radical cystectomy and make a preliminary study of its significance in clinical application.Methods15 male patients confirmed bladder cancer at Zhujiang Hospital going to accept the surgery from October 2014 to June 2017 were collected.According to the CT data,the 3D reconstruction model of bladder and adjacent organs—prostate?vessel?ureter,was performed by the mimics 17.0 software before surgery and used for surgical planning in 7 patients(experimental group).The preoperative planning was performed by CT data among another 8 patients(eontrol group).Patients demographies,operation time,estimated blood loss,eomplication rate were collected and analyzed.Result7 cases were reconstructed,exhibiting the relationship of bladder and closed organs vividly(experimental group).All patients were accepted the surgery successfully.In experimental and control group,the operation time was(201.50±14.86 min vs 219.75±12.32 min,P<0.05),estimated blood loss was(21.14±10.38g/L vs 27.75±7.80g/L,P>0.05),the number of lymph nodes resected were(13.14±5.98 vs 11.50±2.78,P>0.05),overall complication rate was(28.6%vs 50%,P>0.05)_No patient sufferred the damaging for the vascular and nervous.The postoperative pathology were confirmed for muscle invasive urothelial carcinoma for all patients.ConclusionIn vivo male pelvic digitalized 3D model of bladder is safe and effective,helping surgeons understanding the anatomical characteristic of patient,using for preoperative planning,shortening the operation time.