Three‐dimensional modelling as a novel interactive tool for preoperative planning for complex perianal fistulas in Crohn's disease

Author:

Jeri‐McFarlane Sebastián1ORCID,García‐Granero Álvaro12ORCID,Ochogavía‐Seguí Aina1ORCID,Pellino Gianluca34ORCID,Oseira‐Reigosa Anaí1ORCID,Gil‐Catalan Alejandro1ORCID,Brogi Leandro5,Ginard‐Vicens Daniel6,Gamundi‐Cuesta Margarita1,Gonzalez‐Argente Francisco Xavier1ORCID

Affiliation:

1. Colorectal Unit, General and Digestive Surgery Department Hospital Universitario Son Espases Palma de Mallorca Spain

2. Human Embryology and Anatomy Department University of Islas Baleares Mallorca Spain

3. Colorectal Surgery Unit, Vall d'Hebron University Hospital Universitat Autonoma de Barcelona UAB Barcelona Spain

4. Department of Advanced Medical and Surgical Sciences Università degli Studi della Campania Luigi Vanvitelli Naples Italy

5. Simulation and 3D Reconstruction Area Hospital Universitario Son Espases Palma de Mallorca Spain

6. Gastroenterology Department Hospital Universitario Son Espases Palma de Mallorca Spain

Abstract

AbstractAimThe aim of this study is to demonstrate the added value of three‐dimensional (3D) reconstruction models and artificial intelligence for preoperative planning in complex perianal Crohn's disease. MRI is the gold standard for diagnosis of complex perianal fistulas and abscess due to its high sensitivity, but it lacks high specificity values. This creates the need for better diagnostic models such as 3D image processing and reconstruction (3D‐IPR) with artificial intelligence (AI) algorithms.MethodThis is a prospective study evaluating the utility of 3D reconstruction models from MRI in four patients with perineal Crohn's disease (pCD).ResultsFour pCD patients had 3D reconstruction models made from pelvic MRI. This provided a more visual representation of perianal disease and made possible location of the internal fistula orifice, seton placement in fistula tracts and abscess drainage.ConclusionThree‐dimensional reconstruction in CD‐associated complex perianal fistulas can facilitate disease interpretation, anatomy and surgical strategy, potentially improving preoperative planning as well as intraoperative assistance. This could probably result in better surgical outcomes to control perianal sepsis and reduce the number of surgical procedures required in these patients.

Publisher

Wiley

Subject

Gastroenterology

Reference13 articles.

1. ECCO guidelines on therapeutics in Crohn's disease: medical treatment;Torres J;J Crohns Colitis.,2019

2. Surgical strategy for supralevator abscess in Perianal Crohn’s disease: emergency surgery and residual complex fistula

3. Treatment Strategy for Perianal Fistulas in Crohn Disease Patients: The Surgeon’s Point of View

4. Magnetic resonance imaging template to standardize reporting of anal fistulas

5. Three‐dimensional virtual reconstruction as a tool for preoperative planning in the management of complex anorectal fistulas;Júnior ECS;J Coloproctology.,2018

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