MSCTA三维重建对腹腔镜结直肠癌根治术的临床指导价值分析

目的分析多层螺旋CT血管成像(MSCTA)三维重建对腹腔镜结直肠癌根治术的临床指导价值。方法收集2016年6月至2018年6月我院49例行腹腔镜结直肠癌根治术患者(观察组)的临床资料,术前均行MSCTA三维重建,评估肠系膜血管解剖结构,并与实际手术情况进行对比分析,另选择同期行腹腔镜结直肠癌根治术且术前仅进行常规CT平扫和增强扫描的45例患者作为对照组(未行MSCTA三维重建),比较两组围术期指标及术后并发症。结果观察组有46例(93.88%)患者术前以MSCTA三维重建结果制订的手术方式与实际手术相同,kappa一致性检验k=0.814,P<0.05。观察组手术时间、术中出血量、腹腔引流量均少于对照组(P<0.05),淋巴结清扫数量、术后住院时间、术后并发症总发生率与对照组无显著差异(P>0.05)。结论 MSCTA三维重建可明确肠系膜血管解剖结构和结直肠肿瘤位置,可指导腹腔镜结直肠癌根治术顺利实施。

Clinical Guidance Value of Three-dimensional Reconstruction of MSCTA for Laparoscopic Radical Resection of Colorectal Cancer

Objective To analyze the clinical guidance value of three-dimensional reconstruction of multi-slice spiral CT angiography(MSCTA) for laparoscopic radical resection of colorectal cancer. Methods The clinical data of 49 patients undergoing laparoscopic radical resection of colorectal cancer(observation group) in the hospital from June 2016 to June 2018 were collected. Three-dimensional reconstruction of MSCTA was performed before operation to evaluate the anatomical structure of mesenteric vessels and compared it with the actual situation of operation. Another 45 patients who underwent laparoscopic radical resection of colorectal cancer and conventional CT plain and enhanced scan before operation were selected as control group(without threedimensional reconstruction of MSCTA). Perioperative indicators and postoperative complications were compared between the two groups. Results The operation mode of 46 patients(93.88%) in the observation group developed according to the results of three-dimensional reconstruction of MSCTA was the same as actual operation. Kappa consistency test showed k=0.814, P<0.05. The operation time, intraoperative blood loss and abdominal drainage volume of the observation group were shorter/less than those of the control group(P<0.05). There was no significant difference in the number of lymph nodes removed, postoperative hospital stay or postoperative complications(P>0.05). Conclusion Three-dimensional reconstruction of MSCTA can clarify the anatomical structure of mesenteric vessels and the location of colorectal tumors, which can guide the successful implementation of laparoscopic radical resection of colorectal cancer.