中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2011年
1期
31-33
,共3页
谢锷%翁泽生%王小忠%黄耀奎
謝鍔%翁澤生%王小忠%黃耀奎
사악%옹택생%왕소충%황요규
胃肿瘤%多层螺旋CT血管成像%根治手术
胃腫瘤%多層螺鏇CT血管成像%根治手術
위종류%다층라선CT혈관성상%근치수술
Stomach neoplasms%Multi-slice spiral CT angiography%Radical operation
目的 探讨术前行腹部多层螺旋CT血管成像(MSCTA)检查在胃癌根治术中的临床意义.方法 将103例胃癌患者,根据本人意愿分成术前行MSCTA检查组57例(Ⅰ组)和未行MSCTA检查组46例(Ⅱ组),由同一组术者进行手术.结果 Ⅰ组患者经MSCTA检查,发现有6例(10.5%)供胃血管发生变异;全组患者胃周主要血管的位置、走向及与病变的关系术中所见与MSCTA检查诊断符合率为100%;Ⅰ组的手术时间[(206±23)min]比Ⅱ组[(257±32)min]短(95%CI:-22.452～-0.919,P=0.044);Ⅰ组供胃动脉解剖异常患者的手术时间[(190±50)min]比Ⅱ组术中发现异常的3例患者手术时间[(255±62)min]短(95%CI:-100.141～-3.193,P=0.048).而两组病例(包括供胃动脉解剖异常者)术中平均出血量、淋巴结清扫量、并发症发生率、术后住院天数、住院费用比较,差异无统计学意义(均P＞0.05).结论 术前行MSCTA检查,对评估肿瘤血管及周围组织结构、防止因缺乏了解而误伤变异血管或组织器官可提供一定的保障.
目的 探討術前行腹部多層螺鏇CT血管成像(MSCTA)檢查在胃癌根治術中的臨床意義.方法 將103例胃癌患者,根據本人意願分成術前行MSCTA檢查組57例(Ⅰ組)和未行MSCTA檢查組46例(Ⅱ組),由同一組術者進行手術.結果 Ⅰ組患者經MSCTA檢查,髮現有6例(10.5%)供胃血管髮生變異;全組患者胃週主要血管的位置、走嚮及與病變的關繫術中所見與MSCTA檢查診斷符閤率為100%;Ⅰ組的手術時間[(206±23)min]比Ⅱ組[(257±32)min]短(95%CI:-22.452～-0.919,P=0.044);Ⅰ組供胃動脈解剖異常患者的手術時間[(190±50)min]比Ⅱ組術中髮現異常的3例患者手術時間[(255±62)min]短(95%CI:-100.141～-3.193,P=0.048).而兩組病例(包括供胃動脈解剖異常者)術中平均齣血量、淋巴結清掃量、併髮癥髮生率、術後住院天數、住院費用比較,差異無統計學意義(均P＞0.05).結論 術前行MSCTA檢查,對評估腫瘤血管及週圍組織結構、防止因缺乏瞭解而誤傷變異血管或組織器官可提供一定的保障.
목적 탐토술전행복부다층라선CT혈관성상(MSCTA)검사재위암근치술중적림상의의.방법 장103례위암환자,근거본인의원분성술전행MSCTA검사조57례(Ⅰ조)화미행MSCTA검사조46례(Ⅱ조),유동일조술자진행수술.결과 Ⅰ조환자경MSCTA검사,발현유6례(10.5%)공위혈관발생변이;전조환자위주주요혈관적위치、주향급여병변적관계술중소견여MSCTA검사진단부합솔위100%;Ⅰ조적수술시간[(206±23)min]비Ⅱ조[(257±32)min]단(95%CI:-22.452～-0.919,P=0.044);Ⅰ조공위동맥해부이상환자적수술시간[(190±50)min]비Ⅱ조술중발현이상적3례환자수술시간[(255±62)min]단(95%CI:-100.141～-3.193,P=0.048).이량조병례(포괄공위동맥해부이상자)술중평균출혈량、림파결청소량、병발증발생솔、술후주원천수、주원비용비교,차이무통계학의의(균P＞0.05).결론 술전행MSCTA검사,대평고종류혈관급주위조직결구、방지인결핍료해이오상변이혈관혹조직기관가제공일정적보장.
Objectives To explore the clinical significance of preoperative abdominal multislice spiral CT angiography (MSCTA) in radical resection of gastric cancer. Methods One hundred and three patients with gastric cancer were divided into two groups according to their desires. Group Ⅰ included 57 patients who underwent preoperative MSCTA and group Ⅱ included 46 patients who underwent surgery without preoperative MSCTA. All these patients were operated by the same surgical team. Results Six patients (10.5%) with abnormal gastric artery in group Ⅰ were discovered. The diagnostic concordance rate between MSCTA and intraoperative findings was 100% in group Ⅰ in the locations and alignments of main perigastric vessels and their relationship with cancer lesions.Operative time in group Ⅰ was shorter than that in group Ⅱ [(206±23)min vs. (257±32)min, P=0.044]. Operative time [(190±50) min] of patients with abnormal gastric artery of group Ⅰ was shorter than that [(255±62) min] of patients with abnormal gastric artery discovered during operation of group Ⅱ (P=0.048). However there were no differences in blood loss, extent of lymph node dissection,complication rate, length of hospital stay, and hospitalization cost between the two groups (P＞0.05).Conclusion Preoperative MSCTA is beneficial to the evaluation of vascular structure of the cancer and the adjacent tissues, which may reduce postoperative complications.
