Version of preoperative 3D reconstruction of the mesogastric layer in locally advanced cancer of the cardioesophageal junction. Clinical case

Introduction. For the correct staging of stomach cancer, high-quality and reliable visualization is important, including using radiation diagnostic methods. Most often, information about the stage of the disease and the morphological type of the tumor can be obtained only by pathoanatomic examination after a surgical operation. Therefore, the study of the possibilities of radiation diagnostic methods, in particular, computed tomography (CT), has great potential for determining treatment tactics. The purpose of the work. To show the possibility and evaluate the prospects of 3D reconstruction of the mesogastric layer in locally advanced cancer of the cardio-esophageal junction. Materials and methods. The MSCT of a patient with locally advanced cancer of the cardio-esophageal junction was analyzed, with an assessment of the densitometric density of the surrounding perigastric fiber, affected and healthy lymph nodes. Based on this, a 3D model of the stomach with altered perigastric fiber was constructed, an attempt was made to assess the degree of "interest" of the mesogastric layer in order to provide surgeons with a visual picture of the volume of the upcoming operation. These data were compared with the intraoperative picture (including ICG marking) and the results of histological examination. Results. In the area of the removed mesogastric layer, the density of which according to computed tomography was higher than the rest, free tumor deposits were found and areas of lymphovascular tumor invasion, as well as metastatic lymph nodes, were described.