钛夹标记联合CT图像后处理技术在早期胃癌腹腔镜术前定位中的应用

Application of titanium clip labeling combined with CT image post-processing technique in preoperative positioning of laparoscopic surgery for early gastric cancer

目的探讨钛夹标记联合CT图像后处理技术在早期胃癌腹腔镜术前定位中的应用。方法30例早期胃癌患者经消化道内窥镜检查发现病灶并常规活检后,于瘤体旁放置钛夹,术前12~24 h分别行腹部卧位X线摄影及腹部CT平扫,通过CT图像后处理技术及腹部X线摄影来了解钛夹的位置,以便术前确定病灶部位及范围,并与术中所见病灶位置进行比较,评判两种方法对早期胃癌腹腔镜手术的术前定位准确率,并通过CT对胃周围淋巴结转移进行初步评判。结果本组30例患者术前行钛夹标记联合CT图像后处理技术对胃癌的定位与手术结果符合率为100%(30/30),其定位准确率优于钛夹标记联合腹部X线摄影对胃癌的定位方法。所有患者均顺利完成腹腔镜手术。结论对于早期胃癌患者,利用钛夹标记联合CT图像后处理技术是术前准确可靠的病灶定位方法,亦可大体了解胃周围淋巴结的情况,对早期胃癌腹腔镜手术顺利完成有重要的临床意义。

Objective To explore the application of titanium clip labeling combined with CT image post-processing technology in the preoperative localization of laparoscopic surgery for early gastric cancer.Methods 30 patients with early gastric cancer were detected by endoscopic examination and biopsy,titanium clips were placed beside the tumor.Abdominal CT plain scan and abdominal X-ray were performed 12~24 hours before operation.The location of titanium clips was determined by CT image post-processing technology and abdominal X-ray.The location and range of the lesions were compared with those seen during the operation,and the accuracy of these methods in preoperative localization of early gastric cancer by laparoscopy was evaluated,and the perigastric lymph node metastasis was preliminarily evaluated by CT.Results In this study,30 patients with gastric cancer were labeled with titanium clip and abdominal CT examination before operation.The coincidence rate between the localization of gastric cancer and the operation results was 100%(30/30).The accuracy of localization was better than that of the control group with titanium clip labeling combined with abdominal X-ray.All patients were successfully completed laparoscopic surgery.Conclusion For patients with early gastric cancer,Titanium clip labeling combined with CT post-processing reconstruction is an accurate and reliable method for preoperative localization of the lesion,and also provides a general understanding of the perigastric lymph nodes,which has important clinical significance for the successful completion of laparoscopic surgery for early gastric cancer.