目的 研究腹腔镜结肠癌根治术前行腹部螺旋CT血管造影(CT angiography, CTA)和结肠三维成像检查对结肠肿瘤解剖性切除的价值。方法 收集2017-09至2019-02医院80例结肠癌患者资料,按术前检查分为联合成像组和常规CT组,每组40例。比较两组患者基线资料,术中、术后相关指标,分析三维图像所示肿瘤病灶及其供血血管情况。结果 联合成像组患者术中出血量[(137.34±59.68) ml]少于常规CT组[(181.75±53.42) ml](P=0.001);手术耗时[(165.90±47.85) min]短于常规CT组[(192.88±43.16) min](P=0.010);术后腹腔总引流量[(61.03±18.82) ml]少于常规CT组[(73.10±21.16) ml](P=0.009)。腹部CTA联合三维融合图像可直观显示腹腔内各组织器官和结肠肿瘤及其供血血管的全景图像。结论 术前腹部CTA和结肠三维成像检查可明确结肠肿瘤解剖部位及其供血血管,可缩短手术时间、减少术中出血量,具有一定价值,尤其对年轻及手术操作不甚熟练医师可能带来更大帮助。
Abstract
Objective To study the value of abdominal spiral CT angiography (CTA) and three-dimensional imaging of colon before laparoscopic radicalesection of colon cancer. Methods The clinical data of eighty colon cancer patients from September 2017 to February 2019 was collected. According to preoperative examination, patients were divided into two groups: the combined imaging group and the conventional CT group,there were 40 patients in each group. The baseline data, intraoperative and postoperative related indexes were compared.The value of combined imagingof tumor were also analyzed. Results In the combined imaging group, the intraoperative blood loss (137.34±59.68) ml was less than that in the routine CT group (181.75±53.42) ml (P=0.001), the operation time (165.90±47.85) min was shorter than that in the conventional CT group (192.88±43.16) min (P=0.010), and the total postoperative abdominal drainage (61.03±18.82) ml was less than that in the routine CT group (73.10±21.16) ml (P=0.009). CTA combined with three-dimensional fusion images can directly display the panoramic images of various tissues and organs, colon tumors and their blood vessels. Conclusions Preoperative abdominal CTA and three-dimensional imaging of the colon have certain advantages, as this method can identify the anatomical location of the colon tumor and its blood supply vessels, and also can effectively shorten the operation time and reduce the amount of intraoperative bleeding. In addition, it may be more helpful to young and unskilled doctors.
关键词
结肠癌 /
腹腔镜手术 /
螺旋CT血管造影 /
三维成像技术
Key words
colon cancer /
laparoscopic surgery /
spiral CT angiography /
three-dimensional image technology
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