Patient-specific 3D vascular reconstructions improve preoperative planning for right colectomy with complete mesocolic excision: A crossover study - 17/10/26

Doi : 10.1016/j.jviscsurg.2026.10.001

Emma Diallo ^a, Antoine Cazelles ^a, Mélinda Bajul ^a, Aurélien Saltel-Fulero ^b, Lionel Rebibo ^a, Léila M’Harzi ^a, Lucien Maraux ^a, Gianluca Pagano ^a, Pauline Thibodot ^a, Rami Harb ^a, Remy Amory ^a, Sarah Nerriec ^a, Thibault Sigwalt ^a, Mehdi Karoui ^a, Gilles Manceau ^a,⁎

^a Department of Digestive and Oncological Surgery, Georges Pompidou University Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France

^b Department of Radiology, Georges Pompidou University Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France

^⁎ Corresponding author. Paris Cité University, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Digestive and Oncologic Surgery, 20 rue Leblanc, 75015 Paris, France. Paris Cité University, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Digestive and Oncologic Surgery 20 rue Leblanc Paris 75015 France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 17 October 2026

Highlights

•	3D reconstructions improve vascular anatomy interpretation accuracy.
•	Accuracy gains are greatest for complex and clinically relevant vessels.
•	Interpretation time is halved compared with conventional CT.
•	Strongest benefit observed in less experienced surgeons.
•	3D reconstructions may standardize preoperative planning for CME.

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Summary

Introduction

Complete mesocolic excision (CME) for right-sided colon cancer is technically demanding due to substantial variability in mesenteric vascular anatomy. Patient-specific three-dimensional (3D) vascular reconstructions may improve preoperative planning by enhancing the accuracy and efficiency of anatomical analysis. This study assessed the impact of 3D reconstructions on anatomical accuracy and interpretation time compared with conventional CT.

Materials and methods

This retrospective, single-centre comparative study used a cross-over design. Portal-venous phase CT scans were analysed using either conventional CT interpretation or patient-specific 3D vascular reconstructions (Visible Patient®, Strasbourg, France). Readers with different levels of experience assessed right colonic arterial and venous anatomy. Anatomical accuracy and interpretation time were compared using mixed-effects models accounting for reader- and patient-related effects.

Results

Thirty patients and fourteen readers (seven junior and seven senior) were included, yielding 840 imaging assessments. Anatomical accuracy was significantly higher with 3D reconstructions (adjusted OR 2.05, 95% CI 1.76–2.40; P < 0.001), independently of reader experience and reading sequence. Median interpretation time was significantly shorter with 3D reconstructions compared with conventional CT (150 s [110–232] vs. 335 s [203–500], P < 0.0001). In multivariable analysis, 3D reconstructions remained independently associated with reduced interpretation time, with a stronger effect in junior (−60%) than senior readers (−35%).

Conclusion

Patient-specific 3D vascular reconstructions improve both the accuracy and efficiency of preoperative anatomical assessment for right-sided colon surgery compared with conventional CT interpretation. These findings support their integration into preoperative planning for CME, with potential benefits for surgical standardisation and training.

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Keywords : Right colon, Colon cancer, Vascular anatomy, Three-dimensional reconstruction, Preoperative planning