摘要
目的探讨3D重建技术(三维可视化)在低位直肠癌术前评估的临床应用价值。方法收集我院2018年1月至2019年6月行低位直肠癌手术的24例患者,均采用3D重建技术评估手术。以2016年1月至2017年12月未采用3D重建技术的30例低位直肠癌手术患者作为对照组。观察组术前常规CT检查后行三维重建,根据重建结果分析直肠盆腔解剖,进行手术规划及模拟手术,确定手术方案。在3D重建(三维可视化)的指导下行腹腔镜直肠癌根治术(Dixon/Miles)手术。结果观察组24例患者手术均与术前手术规划一致。观察组1例因术中出血中转开腹,对照组2例因显露不佳、1例因术中出血而中转开腹。观察组手术时间、术后肛门排气时间及住院时间均短于对照组,差异均有统计学意义(P<0.05),而两组术中出血量、淋巴结检出数比较,差异无统计学意义(P>0.05)。观察组术后并发症11例,其中吻合口瘘2例,肺部感染2例,肠梗阻2例,尿潴留2例,切口感染3例;对照组术后并发症13例,其中吻合口瘘1例,肺部感染3例,肠梗阻3例,尿潴留2例,切口感染4例;组间比较差异无统计学意义(P>0.05)。所有病例术后至少随访12个月,观察组1年生存率为95.8%,对照组为93.3%,两组比较差异无统计学意义(χ^2=0.159,P=0.69)。结论3D重建技术(三维可视化)可缩短低位直肠癌手术时间,促进患者术后康复,且并未增加患者术中出血、术后并发症的风险,有利于术前规划手术方案,使手术更加精准、安全。
Objective To explore the clinical value of 3D reconstruction(3D visualization)in preoperative evaluation of low rectal cancer.Methods From January 2018 to June 2019,a total of 24 cases underwent low rectal cancer surgery were enrolled as the observation group,and 3D reconstruction technique was applied to evaluate the surgery.A total of 30 low rectal cancer cases performed radical surgery from January 2016 to December 2017 without application of 3D reconstruction technique were regarded as the control group.All cases of the observation group received 3D reconstruction after routine CT examination before the operation.The anatomy of rectum and pelvic cavity,operation planning and simulated surgery were analyzed to determine the surgical program based on the results of 3D reconstruction.Laparoscopic radical surgery of Dixon or Miles were performed under the guidance of 3D reconstruction(3D visualization).Results The operation was consistent with the preoperative operation plan in all 24 cases of the observation group.Four cases conversed to open operation,including 1 case due to intraoperative bleeding in the observation group,2 cases due to large tumor and poor intraoperative exposure and 1 case due to intraoperative bleeding in the control group.There was no death in peri-operative period in both groups.The operation time,postoperative gastrointestinal function recovery time and hospitalization time of the observation group were shorter than those of the control group(P<0.05),while there was no statistical difference in intraoperative blood loss and positive lymph node number between the two groups(P>0.05).Postoperative complications were found in 11 cases in the observation group,including 2 of anastomotic leakage,2 of pulmonary infection,2 of intestinal obstruction,2 of urinary retention and 3 of incision infection,and in 13 cases in the control group,including 1 of anastomotic leakage,3 of pulmonary infection,3 of intestinal obstruction,2 of urinary retention and 4 of incision infection,and there was no signif
作者
江燕飞
张波
刘苏
方圆
陈旭辉
李海军
JIANG Yan-fei;ZHANG Bo;LIU Su;FANG Yuan;CHEN Xu-hui;LI Hai-jun(Department of General Surgery, Shenzhen Luohu People's Hospital, Shenzhen 518001, Guangdong, China)
出处
《中国现代手术学杂志》
2020年第5期332-336,共5页
Chinese Journal of Modern Operative Surgery
关键词
3D重建
三维可视化
直肠癌
低位
术前评估
3D reconstruction
3D visualization
rectal cancer,low
preoperative evaluation
