Application of three-dimensional digital reconstruction of male pelvic cavity in patients with laparoscopic radical prostatectomy

  Objective  To construct a digital three-dimensional model of male pelvic cavity and explore its value in laparoscopic radical prostatectomy.

  Methods  A total of 43 male patients with prostate cancer in the Department of Urinary Surgery of Hefei Hospital Affiliated to Anhui Medical University from November 2019 to October 2021 were randomly divided into experimental group with 21 casesdigital three-dimensional reconstruction based on computed tomography (CT) and magnetic resonance imaging (MRI) data and control group with 22 cases (treated with preoperative planning based on traditional two-dimensional imaging). The clinical data, surgical indexes and incidence of complication were compared between two groups.

  Results  In this study, the three-dimensional models of the pelvic cavity of 21 male patients in the experimental group were successfully reconstructed, and each tissue was marked with different colors, which was able to directly display the pelvic structures such as bladder, prostate, seminal vesicle gland, pelvis, nerves and blood vessels, and also had the functions of adjusting tissue contrast, enlarging or reducing the model and rotation. All of the 43 patients in this study successfully completed laparoscopic radical prostatectomy, and all the postoperative pathological results showed they had prostate adenocarcinoma. There were no significant differences in clinical data between the two groups (P>0.05). The average operation time of the experimental group was significantly shorter than that of the control group (P=0.010); there were no significant differences in intraoperative bleeding, lymph node metastasis rate and positive rate of cutting edge between the two groups (P=0.114, 0.705, 0.488). At 1 month and 3 months after operation, the incidence rates of urinary incontinence in the experimental group were significantly lower than those in the control group (P=0.026, 0.048).

  Conclusion  Three-dimensional reconstruction of male pelvic structure is helpful for the operator to plan the individualized operation scheme, improve the curative effect of laparoscopic radical prostatectomy, shorten the operation time and reduce the incidence of postoperative urinary incontinence.