The use of rotational fluoroscopy and 3-D reconstruction in the diagnosis and surgical planning for complex cloacal malformations

Reck-Burneo, Carlos A.; Lane, Victoria A.; Bates, D. Gregory; Hogan, Mark; Thompson, Ben; Gasior, Alessandra C.; Weaver, Laura; Dingemans, Alexander J.M.; Maloof, Tassiana; Hoover, Erin; Gagnon, Renae; Wood, Richard J.; Levitt, Marc A.

doi:10.1016/j.jpedsurg.2019.03.016

Cited by 14 publications

(11 citation statements)

References 4 publications

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“…The CC length can be measured from the distal vagina or rectum fistula to the perineum (labia minora) [1]. PC is traditionally categorized into short (< 3 cm) and long (> 3 cm) types based on the length of the CC [1,2].…”

Section: Discussionmentioning

confidence: 99%

“…Traditional 2-D FCS images may present with structural overlap, image foreshortening, internal reference absence, and magnification errors, while MRI cannot clearly display the thin tubular structures such as urethra, rectal fistula and CC [1,8]. 3-D reconstruction with rotational fluoroscopy [2,8] or Dyna-CT [4] has been successfully utilized for preoperative anatomical evaluation of complex cloacal malformations, but its disadvantages include general anesthesia and high radiation exposure. CT should be reserved for complex cases if MRI is unavailable [7].…”

Section: Discussionmentioning

confidence: 99%

“…Persistent cloaca (PC) is the most intricate anorectal malformation characterized by a convergence of the urethra, vagina, and rectum forming into a narrow common channel in the perineum [1,2]. Antenatal ultrasound and fetal magnetic resonance imaging (MRI) can provide the important clues for prenatal diagnosis of cloacal malformations [3].…”

Section: Introductionmentioning

confidence: 99%

“…Antenatal ultrasound and fetal magnetic resonance imaging (MRI) can provide the important clues for prenatal diagnosis of cloacal malformations [3]. Preoperative visualization and measurement of structural relationships is obligatory for the surgical repair, and preoperative evaluation methods including endoscopy, ultrasonography, fluoroscopy contrast study (FCS), 3-D fluoroscopic reconstruction, and MRI have been feasible [1,2,4]. Contrast-enhanced ultrasound (CEUS) has been used safely for hepatic, renal, splenic, vascular, and intracavitary assessment in children [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Preoperative evaluation of persistent cloaca using contrast-enhanced ultrasound in an infant

Lin

Yang

et al. 2020

Med Ultrason

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Persistent cloaca (PC) is the most intricate anorectal malformation. Contrast-enhanced ultrasound (CEUS) is safe for hepatic, renal, splenic, vascular, and intracavitary assessment in children, but it is little applied for cloacal malformation. Our results demonstrate that CEUS can not only display the uterine, vagina, bladder, urethra, rectum, and rectovaginal fistula, but also measure the length of the common channel, bladder neck to the common channel, and distal urethra to the perineum. To our knowledge this may be the first report of preoperative evaluation by CEUS in an infant with PC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Preoperative evaluation of persistent cloaca using contrast-enhanced ultrasound in an infant

Lin

Yang

et al. 2020

Med Ultrason

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“…These reconstructed images have also been shown to yield comparable results with endoscopic measurements. 6 7 8 9 In addition, bedside model printing might gain increasing importance in medical training and education in the future. As demonstrated by other groups, simulation and skills training is an important aspect to increase patient safety for neonates, infants, and children.…”

Section: Introductionmentioning

confidence: 99%

Cysto-Vaginoscopy of a 3D-Printed Cloaca Model: A Step toward Personalized Noninvasive Preoperative Assessment in Patients with Complex Anorectal Malformations

et al. 2021

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Introduction For the classification of the complexity of cloacal malformations and the decision on the operative approach, an exact anatomical assessment is mandatory. To benefit from using three-dimensional (3D)-printed models in preoperative planning and training, the practicability of these models should be guaranteed. The aim of this study was to evaluate the quality and feasibility of a real-size 3D-printed cloaca model for the purpose of cysto-vaginoscopic evaluation. Materials and Methods We performed a 3D reconstruction and printed a real-size, rubber-like 3D model of an infant pelvis with a cloacal malformation and asked invited pediatric surgeons and pediatric urologists to perform a cysto-vaginoscopy on the model and to complete a brief questionnaire to rate the quality and feasibility of the model and to indicate whether they would recommend the model for preoperative planning and training. Results Overall, 41 participants rated the model quality as good to very good (M = 3.28, standard deviation [SD] = 0.50, on a scale from 1 to 4). The model was rated as feasible for preoperative training (M = 4.10, SD = 0.75, on a scale from 1 to 5) and most participants (85.4%) would recommend the model for preoperative training. The cysto-vaginoscopy of the model was considered as a valid training tool for real-life cases and improved the confidence on the anatomy of a cloaca. Conclusion The results of our study indicate that patient-specific 3D-printed models might be a useful tool in the preoperative evaluation of complex anorectal malformations by simulation of cysto-vaginoscopy with an excellent view on anatomical structures to assess the whole spectrum of the individual cloacal malformation. Our model might be a valuable add-on tool for specialty training in pediatric colorectal surgery.

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The use of rotational fluoroscopy and 3-D reconstruction in the diagnosis and surgical planning for complex cloacal malformations

Cited by 14 publications

References 4 publications

Preoperative evaluation of persistent cloaca using contrast-enhanced ultrasound in an infant

Preoperative evaluation of persistent cloaca using contrast-enhanced ultrasound in an infant

Cysto-Vaginoscopy of a 3D-Printed Cloaca Model: A Step toward Personalized Noninvasive Preoperative Assessment in Patients with Complex Anorectal Malformations

The use of a Meckel's diverticulum for a neo-vagina in a patient with cloacal anomaly

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