Precise examination and diagnosis of small intestinal tumors is difficult because of the curved course and overlapping canal of the small intestine. Traditional technology for intestinal canal examination and endoscop...Precise examination and diagnosis of small intestinal tumors is difficult because of the curved course and overlapping canal of the small intestine. Traditional technology for intestinal canal examination and endoscopy cannot exhibit the intestinal wall and extra-luminal structure well. With the development and advancement of multi-slice spiral computed tomography and magnetic resonance imaging (MRI), computed tomography enteroclysis (CTE) and magnetic resonance enteroclysis (MRE) are widely used in the examination and diagnosis of small intestinal tumors. CTE and MRE, with three-dimensional imaging capabilities and excellent soft-tissue contrast, can analyze the abnormalities of peripheral intestinal structure as well as the tunica mucosa. In addition, these two technologies can clearly reveal the localization, appearance, degree of mesenteric infiltration and remote tumor metastasis, which increases our cognition of the imaging diagnosis for intestinal tumors. Here we review recent progress in imaging (CT and MRI) examination and diagnosis of small intestinal tumors.展开更多
目的探讨腹腔镜在小肠肿瘤诊治中的价值。方法脐孔穿刺建立气腹,置入腹腔镜,于左右腹直肌外侧缘各置入5 mm trocar。探查明确小肠肿瘤的部位,上腹正中线或下腹正中做长3~4 cm切口,切口保护器保护切口,良性肿瘤行小肠局部切除,恶性肿瘤...目的探讨腹腔镜在小肠肿瘤诊治中的价值。方法脐孔穿刺建立气腹,置入腹腔镜,于左右腹直肌外侧缘各置入5 mm trocar。探查明确小肠肿瘤的部位,上腹正中线或下腹正中做长3~4 cm切口,切口保护器保护切口,良性肿瘤行小肠局部切除,恶性肿瘤行根治性切除,端端或侧侧吻合肠管,关闭小肠系膜孔,缝合穿刺孔。结果 24例均在腹腔镜下诊断和手术,其中23例腹腔镜辅助下行部分小肠肠段切除,1例行腹腔镜辅助下右半结肠切除。手术时间(70.3±21.7)min,术中出血量(18.5±3.1)ml,切口长度(3.5±1.1)cm,术后肛门排气时间为(2.5±0.5)d。术后病理:良性肿瘤8例,平滑肌瘤多见,5例;恶性肿瘤16例,间质瘤多见,6例。术后住院时间(6.5±2.5)d。19例随访0.5~4.5年,平均2.6年,其中良性肿瘤6例,恶性肿瘤13例,1例小肠腺癌腹腔内广泛转移死亡,其余18例无肿瘤复发。结论腹腔镜不仅能明确小肠肿瘤的诊断,处理小肠肿瘤安全可行。展开更多
基金Supported by Shanghai Leading Academic Discipline Project,No. S30203
文摘Precise examination and diagnosis of small intestinal tumors is difficult because of the curved course and overlapping canal of the small intestine. Traditional technology for intestinal canal examination and endoscopy cannot exhibit the intestinal wall and extra-luminal structure well. With the development and advancement of multi-slice spiral computed tomography and magnetic resonance imaging (MRI), computed tomography enteroclysis (CTE) and magnetic resonance enteroclysis (MRE) are widely used in the examination and diagnosis of small intestinal tumors. CTE and MRE, with three-dimensional imaging capabilities and excellent soft-tissue contrast, can analyze the abnormalities of peripheral intestinal structure as well as the tunica mucosa. In addition, these two technologies can clearly reveal the localization, appearance, degree of mesenteric infiltration and remote tumor metastasis, which increases our cognition of the imaging diagnosis for intestinal tumors. Here we review recent progress in imaging (CT and MRI) examination and diagnosis of small intestinal tumors.
文摘目的探讨腹腔镜在小肠肿瘤诊治中的价值。方法脐孔穿刺建立气腹,置入腹腔镜,于左右腹直肌外侧缘各置入5 mm trocar。探查明确小肠肿瘤的部位,上腹正中线或下腹正中做长3~4 cm切口,切口保护器保护切口,良性肿瘤行小肠局部切除,恶性肿瘤行根治性切除,端端或侧侧吻合肠管,关闭小肠系膜孔,缝合穿刺孔。结果 24例均在腹腔镜下诊断和手术,其中23例腹腔镜辅助下行部分小肠肠段切除,1例行腹腔镜辅助下右半结肠切除。手术时间(70.3±21.7)min,术中出血量(18.5±3.1)ml,切口长度(3.5±1.1)cm,术后肛门排气时间为(2.5±0.5)d。术后病理:良性肿瘤8例,平滑肌瘤多见,5例;恶性肿瘤16例,间质瘤多见,6例。术后住院时间(6.5±2.5)d。19例随访0.5~4.5年,平均2.6年,其中良性肿瘤6例,恶性肿瘤13例,1例小肠腺癌腹腔内广泛转移死亡,其余18例无肿瘤复发。结论腹腔镜不仅能明确小肠肿瘤的诊断,处理小肠肿瘤安全可行。
