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CTA在腹腔镜辅助胃癌D2根治术前评估中的应用
  • ISSN号:1007-3205
  • 期刊名称:《河北医科大学学报》
  • 时间:0
  • 分类:R735.2[医药卫生—肿瘤;医药卫生—临床医学]
  • 作者机构:[1]河北医科大学第一医院普通外科,河北石家庄050031, [2]河北医科大学第一医院放射科,河北石家庄050031, [3]河北省石家庄市第三医院重症医学科,河北石家庄050011
  • 相关基金:河北省医学科学研究重点课题(20110288);河北省医学科学研究重点课题(20150632);河北省医学科学研究重点课题(ZD20140290)
中文摘要:

目的探讨CT血管造影(CT angiography,CTA)在腹腔镜辅助胃癌D2根治术前检查中的价值。方法选取经胃镜检查证实为胃癌而行腹腔镜胃癌根治术患者54例,按检查方式的不同分为试验组26例与对照组28例。术前所有患者均行腹部CT检查,试验组加用容积再现(volume rendering,VR)技术生成胃周血管三维图像,所有患者行腹腔镜胃癌D2根治术。比较2组手术情况及淋巴结清扫数目,并观察CTA对其胃周血管及其变异显示情况。结果试验组26例胃癌患者,CTA对其胃左动脉、胃网膜右动脉、肝总动脉、肝固有动脉及胃十二指肠动脉的显示率达到了100.0%,对其胃右动脉的显示率为57.7%,对胃网膜左动脉的显示率为53.8%;CTA显示腹腔干及肝动脉相关变异5例(19.2%)。试验组手术时间与术中出血量均少于对照组,差异有统计学意义(P〈0.05)。结论对进展期胃癌拟行腹腔镜手术患者,术前行CTA检查可准确显示胃周血管走形及变异情况、肿瘤与周围组织关系及侵犯程度,有助于制定手术方案并指导术中淋巴结清扫,可有效缩短手术时间,避免损伤血管,减少术中出血量,实现真正微创的目的。

英文摘要:

Objective To explore the value of CT angiography(CTA) in the preoperative examination of radical gastrectomy.Methods Fifty-four patients with gastric cancer who were confirmed by gastroscopy and proposed laparoscopic radical gastrectomy according to the inspection method were divided into two groups: 26 patients with the experimental group and 28 patients with the control group.All patients underwent abdominal CT examination before operation,and the patients in the experimental group were added with volume rendering techniques to generate three-dimensional images of the gastric vessels,and all patients underwent laparoscopic radical gastrectomy for gastric cancer(D2).The operation and the number of lymph node dissection were compared between the 2 groups,and the variations of CTA in the peripheral vessels and the peripheral arteries were observed.Results In the experimental group,26 patients with gastric cancer were treated with laparoscopic radical gastrectomy,CTA for the left gastric artery,right gastroepiploic artery,common hepatic artery,properhepatic artery,and gastroduodenal artery could visualize at 100.0% and the right gastric artery at a percentage of 57.7%,and left gastroepiploic artery at a percentage of 53.8%,CTA showed celiac axis and hepatic artery variation in 5 cases(19.2%).The operation time and the amount of bleeding in the experimental group were less than those in the control group,the difference was statistically significant(P〈0.05).Conclusion For patients with advanced gastric cancer undergoing laparoscopic surgery,preoperative CTA examination can accurately show the gastric vessels and mutation,tumor surrounding tissue relationship and degree of invasion,help to develop surgical procedures and to guide the operation of lymphatic dissection,effectively shorten the operation time,avoid damage to blood vessels,reduce the amount of intraoperative blood loss,and achieve a truly minimally invasive purposes.

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期刊信息
  • 《河北医科大学学报》
  • 中国科技核心期刊
  • 主管单位:河北省教育厅
  • 主办单位:河北医科大学
  • 主编:段惠军
  • 地址:河北省石家庄市中山东路361号
  • 邮编:050017
  • 邮箱:hbydxb@sina.com
  • 电话:0311-86266947
  • 国际标准刊号:ISSN:1007-3205
  • 国内统一刊号:ISSN:13-1209/R
  • 邮发代号:18-31
  • 获奖情况:
  • 河北省优秀科技期刊
  • 国内外数据库收录:
  • 美国化学文摘(网络版),中国中国科技核心期刊
  • 被引量:13331