术前血管CTA在腹腔镜右半结肠中的应用

Application of Preoperative Vascular CTA in Laparoscopic Right Colon

目的探讨术前行肠系膜血管CTA三维成像在腹腔镜右半结肠手术中的价值。方法回顾性分析2018年1月—2018年12月徐州市中心医院胃肠外科收治的78例患者的资料,所有患者均在腹腔镜下行右半结肠癌D3根治术,术前均进行腹部CT扫描,其中行肠系膜上血管CTA三维重建组(CTA组)患者33例,仅行增强CT检查(对照组)45例,比较两组术中及术后各项指标:手术时间、术中出血量、肿瘤大小、术中淋巴结数、术后排气时间、术后并发症(切口感染、吻合口瘘、炎性肠梗阻、肺部感染等)。结果CTA组与对照组,性别、年龄、身体质量指数(BMI)及ASA分级比较差异无统计学意义(P>0.05)。CTA组患者的手术时长、术中出血量和术后排气时间均低于对照组,差异有统计学意义(P<0.05)、两组肿瘤大小、淋巴结清扫数及并发症发生率差异无统计学意义(P>0.05),结论术前行肠系膜血管CTA三维重建,了解血管走形及变异等情况,可有效缩短手术时间,减少出血量,减少副损伤,利于患者术后的恢复。

Objective To explore the value of preoperative threedimensional CTA imaging of mesenteric vessels in laparoscopic assisted right hemicolectomy.Methods From January 2018 to December 2018,78 patients undergoing laparoscopic right colon surgery in Xuzhou Central Hospital were analyzed.33 patients in CTA group and 45 patients in control group.The operative time,intraoperative bleeding volume,tumor size,number of lymph nodes,exhaust time and complications were compared between the two groups.Results There was no significant difference in gender,age,BMI and ASA grade between the two groups(P>0.05).The operation time,bleeding volume and exhaust time in CTA group were lower than those in control group(P<0.05).There was no significant difference in tumor size,lymph node number and complications between the two groups(P>0.05).Results Preoperative mesenteric vascular CTA can shorten the operation time,reduce bleeding and facilitate the recovery of patients.