目的:探究磁共振(MRI, Magnetic Resonance Imaging)中酰胺质子转移成像序列(APT, Amide Proton Transfer Imaging)对评估直肠癌淋巴结转移的价值。方法:我们选取了2022年3月至2023年10月安徽医科大学第二附属医院普外科收治的直肠癌患...目的:探究磁共振(MRI, Magnetic Resonance Imaging)中酰胺质子转移成像序列(APT, Amide Proton Transfer Imaging)对评估直肠癌淋巴结转移的价值。方法:我们选取了2022年3月至2023年10月安徽医科大学第二附属医院普外科收治的直肠癌患者40例,术后病理均明确为直肠癌,其中出现淋巴结转移的18例,无淋巴结转移的22例。所有患者在术前均行盆腔磁共振成像检查,且在检查序列中增加APT序列扫描,并获得APT值,同时收集患者一般临床资料,采用单因素分析及多因素logistic回归分析直肠癌淋巴结转移的相关危险因素。结果:单因素分析结果提示:直肠癌淋巴结转移与直肠癌患者的CEA值,肿瘤距肛门距离、肿瘤直径、肿瘤的T分期及APT信号强度有关(P < 0.05)。多因素分析结果提示:肿瘤距肛门距离、肿瘤的T分期与APT信号强度为直肠癌出现淋巴结转移的独立影响因素(P < 0.05)。结论:APT信号强度是判断直肠癌淋巴结转移的独立危险因素,APT信号强度越高,提示淋巴结转移可能越大。展开更多
背景:探讨腹腔镜全胃切除术中应用手工吻合和管型吻合的手术疗效及其对预后的影响。方法:我们回顾性分析了安徽医科大学第二附属医院胃肠外科2021年10月至2023年10月间收治的112例行腹腔镜全胃切除术胃癌患者的临床病理资料,并将其分为...背景:探讨腹腔镜全胃切除术中应用手工吻合和管型吻合的手术疗效及其对预后的影响。方法:我们回顾性分析了安徽医科大学第二附属医院胃肠外科2021年10月至2023年10月间收治的112例行腹腔镜全胃切除术胃癌患者的临床病理资料,并将其分为手工吻合组(H组,N = 60)和管型吻合组(C组,N = 52),比较腹腔镜全胃切除术中应用手工吻合与管型吻合的手术疗效和预后情况。结果:两组在术中出血量、首次排气时间、术后住院时间、术后并发症等方面的差异均无统计学意义(P > 0.05)。H组的食管空肠吻合时间(20.40 ± 1.83 vs 34.71 ± 1.80)及手术时间更短(252.60 ± 21.91 vs 267.40 ± 19.42)、切口更小(5.07 ± 0.65 vs 10.47 ± 0.87)、住院费用更低(59496.04 ± 5555.51元 vs 64656.13 ± 4340.65元) (P Objective: To investigate the surgical efficacy of applying manual and tubular anastomoses in laparoscopic total gastrectomy and its impact on prognosis. Methods: Retrospective analysis is adopted to the clinicopathologic data of 112 patients with gastric cancer (GC) who went through LTG in the Department of General Surgery, the Second Affiliated Hospital of Anhui Medical University between October 2020 and October 2022. Among them, 60 individuals receiving medical care were split into the hand-sewn anastomosis group (Group H, N = 60);while, 52 individuals were split into the circular stapler anastomosis group (Group C, N = 52) The clinical efficacy and prognostic conditions of hand-sewn anastomosis are compared with those of circular stapler anastomosis in the application of LTG. Results: The analysis results indicated that no notable difference was observed in intraoperative bleeding volume, time to first flatus (TFF), postoperative hospitalization duration and postoperative complications among the two groups (P > 0.05). Group H had shorter esophagojejunal anastomosis time (20.40 ± 1.83 vs 34.71 ± 1.80) and operative time (252.60 ± 21.91 vs 267.40 ± 19.42), smaller incision (5.07 ± 0.65 vs 10.47 ± 0.87), and lower hospitalisation cost (59496.04 ± 5555.51 yuan vs 64656.13 ± 4340.65 yuan) (P < 0.05). Conclusion: The clinical efficacy and the postoperative complications of hand-sewn esophagojejunostomy are basically equivalent in comparison to the circular stapler anastomosis in the application of LTG. Its advantage lies in shorter esophagojejunal anastomosis duration, shorter surgery duration, smaller incisions, lower hospitalization costs and wider adaptability of the location of the tumor.展开更多
文摘背景:探讨腹腔镜全胃切除术中应用手工吻合和管型吻合的手术疗效及其对预后的影响。方法:我们回顾性分析了安徽医科大学第二附属医院胃肠外科2021年10月至2023年10月间收治的112例行腹腔镜全胃切除术胃癌患者的临床病理资料,并将其分为手工吻合组(H组,N = 60)和管型吻合组(C组,N = 52),比较腹腔镜全胃切除术中应用手工吻合与管型吻合的手术疗效和预后情况。结果:两组在术中出血量、首次排气时间、术后住院时间、术后并发症等方面的差异均无统计学意义(P > 0.05)。H组的食管空肠吻合时间(20.40 ± 1.83 vs 34.71 ± 1.80)及手术时间更短(252.60 ± 21.91 vs 267.40 ± 19.42)、切口更小(5.07 ± 0.65 vs 10.47 ± 0.87)、住院费用更低(59496.04 ± 5555.51元 vs 64656.13 ± 4340.65元) (P Objective: To investigate the surgical efficacy of applying manual and tubular anastomoses in laparoscopic total gastrectomy and its impact on prognosis. Methods: Retrospective analysis is adopted to the clinicopathologic data of 112 patients with gastric cancer (GC) who went through LTG in the Department of General Surgery, the Second Affiliated Hospital of Anhui Medical University between October 2020 and October 2022. Among them, 60 individuals receiving medical care were split into the hand-sewn anastomosis group (Group H, N = 60);while, 52 individuals were split into the circular stapler anastomosis group (Group C, N = 52) The clinical efficacy and prognostic conditions of hand-sewn anastomosis are compared with those of circular stapler anastomosis in the application of LTG. Results: The analysis results indicated that no notable difference was observed in intraoperative bleeding volume, time to first flatus (TFF), postoperative hospitalization duration and postoperative complications among the two groups (P > 0.05). Group H had shorter esophagojejunal anastomosis time (20.40 ± 1.83 vs 34.71 ± 1.80) and operative time (252.60 ± 21.91 vs 267.40 ± 19.42), smaller incision (5.07 ± 0.65 vs 10.47 ± 0.87), and lower hospitalisation cost (59496.04 ± 5555.51 yuan vs 64656.13 ± 4340.65 yuan) (P < 0.05). Conclusion: The clinical efficacy and the postoperative complications of hand-sewn esophagojejunostomy are basically equivalent in comparison to the circular stapler anastomosis in the application of LTG. Its advantage lies in shorter esophagojejunal anastomosis duration, shorter surgery duration, smaller incisions, lower hospitalization costs and wider adaptability of the location of the tumor.
