Value of three-dimensional reconstruction of multi-slice spiral CT angiography in laparoscopic radical resection of colorectal cancer

DU Nailiang; WANG Ting; HU Zhifeng; ZHUANG Qianchun

doi:10.19732/j.cnki.2096-6210.2019.03.013

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Value of three-dimensional reconstruction of multi-slice spiral CT angiography in laparoscopic radical resection of colorectal cancer

更新时间：2025-12-15

- Value of three-dimensional reconstruction of multi-slice spiral CT angiography in laparoscopic radical resection of colorectal cancer
- Vol. 28, Issue 3, Pages: 193-197(2019)
- 作者机构：
  
  1. 江苏省淮安市淮阴医院影像中心,江苏,淮安,223300
  2. 江苏省淮安市淮阴医院普外科,江苏,淮安,223300
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2019.03.013
  CLC：
- Published Online：19 July 2019，
  
  Published：19 July 2019
- 稿件说明：
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杜乃亮,王庭,胡志峰,等. 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价值研究[J]. 肿瘤影像学, 2019, 28(3): 193-197 https://doi.

org/10.19732/j.cnki.2096-6210.2019.03.013
杜乃亮,王庭,胡志峰,等. 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价值研究[J]. 肿瘤影像学, 2019, 28(3): 193-197 https://doi. DOI： 10.19732/j.cnki.2096-6210.2019.03.013.

org/10.19732/j.cnki.2096-6210.2019.03.013 DOI：

摘要

目的：

探讨多层螺旋CT（multi-slice spiral CT，MSCT）血管造影三维重建技术在腹腔镜结直肠癌根治术术前评估中的价值。

方法：

回顾性收集2016年3月2018年3月行腹腔镜结直肠癌根治术的患者92例，根据术前是否行MSCT血管造影三维重建将患者分为重建组52例和非重建组40例。比较两组手术指标（术中出血量、手术时间及总淋巴结清扫数）和术后指标（首次肛门排气时间、腹腔引流量及住院时间），采用Kappa一致性检验分析重建组术前手术方案设计与实际手术方案的一致性。

结果：

重建组52例患者均顺利进行腹腔镜下结直肠癌根治术，术前MSCT血管造影三维重建对肠系膜主要血管均显示。重建组术中出血量、手术时间及腹腔引流量小于非重建组［（89.3511.68） mL

. （112.5435.69）mL、（152.3739.51）min

.（193.3562.73） min、（185.3226.94） mL

. （293.5145.6） mL，

＜0.05］，淋巴结清扫数、首次肛门排气时间、住院时间与非重建组无差异［（31.6211.95）个

. （30.0210.14）个（2.410.93）d

.（2.730.95） d、（9.051.82） d

.（9.232.05） d，

＞0.05］。47例患者MSCT血管造影三维重建拟定的手术方案与术中一致，符合率为90.38%（Kappa=0.829，

＜0.05）。

结论：

术前MSCT血管造影三维重建有利于提高腹腔镜结直肠癌根治术的效率和安全性，通过三维重建拟定的手术方案对实际手术操作具有前瞻性指导价值。

Abstract

Objective:

To evaluate the value of three-dimensional reconstruction of multi-slice spiral CT (MSCT) angiography in preoperative evaluation of laparoscopic radical resection of colorec

tal cancer.

Methods:

A total of 92 cases with laparoscopic radical resection of colorectal cancer were collected from Mar. 2016 to Mar. 2018. They were divided into reconstruction group (

=52) and non-reconstruction group (

=40). The surgical indicators (intraoperative bleeding volume

operation time

total lymphatic clearance) and postoperative indicators (first anus exhaust time

abdominal drainage volume

and length of hospital stay) were compared. The Kappa conformance test was used to determine the consistency between preoperation plan and actual operation plan in reconstruction group.

Results:

All the patients in the reconstruction group underwent laparoscopic radical resection of colorectal cancer. Preoperative three-dimensional reconstruction of MSCT angiography showed the main mesenteric vessels. The intraoperative blood loss

operation time

and abdominal drainage volume in reconstruction group were lower than those in nonreconstruction group ［(89.3511.68) mL

. (112.5435.69) mL

(152.3739.51) min

. (193.3562.73) min

(185.3226.94) mL

. (293.5145.6) mL

＜0.05］. There was no significant difference in the number of resected lymph nodes

first anus exhaust time

and length of hospital stay between the two groups ［(31.6211.95)

. (30.0210.14)

(2.410.93) d

. (2.730.95) d

(9.051.82) d

. (9.232.05) d

＞0.05］. The preoperative plan based on three-dimensional reconstruction of MSCT angiography in 47 cases was consistent with the actual operation plan. The coincidence rate was 90.38% (Kappa=0.829

＜0.05).

Conclusion:

Preoperative three-dimensional reconstruction of MSCT angiography is conducive to improve the efficiency and safety of laparoscopic radical resection of colorectal cancer. The proposed surgical plan based on three-dimensional reconstruction has a prospective guiding value for the actual operation.

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