多层螺旋CT血管造影三维重建在腹腔镜结直肠癌根治术中的临床指导价值

Clinical Value of Three-Dimensional Reconstruction Under Multi-slice Spiral CT Angiography in Laparoscopic Radical Resection of Colorectal Carcinoma

目的探究腹腔镜结直肠癌根治术中,多层螺旋CT血管造影(MSCTA)的应用价值。方法选取2018年10月至2019年10月自贡市第四人民医院收治的130例结直肠癌患者为研究对象,根据手术方式的不同分为对照组和试验组,每组65例。对照组直接进行结直肠癌根治术,试验组在结直肠癌根治术前实施MSCTA三维重建,比较两组治疗结局。结果两组患者性别、肿瘤部位等一般资料比较,差异无统计学意义(P>0.05)。与对照组相比,试验组肠系膜下动脉根部与腹主动脉分叉点的距离(D1)、肠系膜下动脉根部与腹主动脉分叉点发出第一分支的距离(D2)平均长度明显缩短(P<0.05)。试验组手术时间与住院时间均短于对照组,差异有统计学意义(P<0.05);试验组术中出血量、腹腔引流量均少于对照组,差异有统计学意义(P<0.05);两组肛门排气时间、淋巴清扫数比较,差异无统计学意义(P>0.05)。对照组、试验组并发症总发生率分别为15.38%、3.08%,差异有统计学意义(P<0.05)。结论结直肠癌患者接受腹腔镜根治术前,采用MSCTA三维重建有助于提升定位精确度,缩短手术时间,减少出血量,缩小D_(1)、D_(2)长度,帮助施术者制定准确手术方案,且并发症减少,值得推广。

Objective To explore the application value of multi-slice spiral CT angiography(MSCTA)in laparoscopic radical resection of colorectal carcinoma.Methods A total of 130 patients with colorectal carcinoma admitted to the Fourth People’s Hospital of Zigong City from October 2018 to October 2019 were selected as research objects.According to different surgical methods,they were divided into control group and experimental group,with 65 patients in each group.The control group received radical resection of colorectal carcinoma,while the experimental group was given MSCTA three-dimensional reconstruction before radical resection of colorectal carcinoma.And the treatment outcomes of the two groups were compared.Results There was no statistically significant difference between the two groups in general data such as gender and tumor site(P>0.05).Compared with the control group,the distance between the root of inferior mesenteric artery and the bifurcation point of abdominal aorta(D1)and the distance between the root of inferior mesenteric artery and the first branch of abdominal aorta(D2)in the experimental group were significantly shorter(P<0.05).The duration of operation and hospital stay in the experimental group were shorter than those in the control group,and the difference was statistically significant(P<0.05).The intraoperative blood loss and abdominal drainage volume in the experimental group were less than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference between the two groups in anal exhaust time and lymphatic dissection number(P>0.05).The total incidence of complications in the control group and the experimental group were 15.38% and 3.08%,respectively,and the difference was statistically significant(P<0.05).Conclusion Before laparoscopic radical resection for colorectal carcinoma patients,MSCTA three-dimensional reconstruction is helpful to improve positioning accuracy,shorten the duration of surgery,reduce the amount of blood loss,reduce the length of D1 and D2,help the surgeon make accurate surgical plans,and reduce complications,which is worthy of promotion.