Application of spectral CT in D3 lymphadenectomy under a laparoscope for treating right-sided colorectal cancer

Objective: The positive aspects of using spectral CT in D3 lymphadenectomy under a laparoscope for the treatment of right-sided colorectal cancer (CRC) are discussed. Methods: : We enrolled right-sided CRC patients (n=40) and preoperative examinations by spectral CT revealed no distant metastasis. The pattern and orientation of the colon, tumor location, the positional correlation of lymph nodes and vessels, and the anatomy and alterations of key blood vessels were probed. Further, the relative spatial positions of different vessels were investigated using the 3D reconstruction technology of spectral CT. Finally, the results were compared with those observed during surgery. Results: : Examination using spectral CT, 3D reconstruction, and data analysis were performed for all 40 cases with successful completion of all the surgeries. Overall, the pattern and orientation of the colon, tumor location, the relation of lymph nodes and blood vessels, and the anatomy and variation of key blood vessels observed during surgery were identical to the 3D reconstructed images obtained by spectral CT before the surgery. This suggests that the accuracy of 3D reconstruction reached 100%. Conclusion: The application of the 3D reconstruction technology of spectral CT before D3 lymphadenectomy under a laparoscope can help to visualize and determine the correlation between the location of a lesion and the anatomical location, hence assisting the surgery.