高分辨MRI评估对低位直肠癌保肛手术中的意义及其疗效的影响

doi:10.3760/cma.j.cn113855-20200321-00230

科研成果详情

题名	高分辨MRI评估对低位直肠癌保肛手术中的意义及其疗效的影响
其他题名	Clinical effects of high resolution magnetic resonance imaging examination on the evaluation for lower rectal cancer undergoing sphincter-preserving operation
作者	陈邦飞(); 杨超颖1; 金纯2; 周崇俊2
发表日期	2020
发表期刊	中华普通外科杂志影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	直肠肿瘤磁共振波谱学保肛手术
其他关键词	Rectal neoplasms ; Magnetic resonance spectroscopy ; Sphincter-preserving operation
摘要	目的评价术前高分辨MRI参数对低位直肠癌手术层面的界定及保肛的意义和临床疗效的影响。方法回顾性分析2017年4月至2018年11月在温州医科大学附属第二医院接受保肛手术治疗的低位直肠癌患者72例,包括腹腔镜手术35例,开腹手术37例,术前均通过MRI检查评估,分析其对低位直肠癌临床分期的诊断价值及保肛手术的安全性和近期疗效。结果与术后病理结果比较,术前MRI检查评估T分期的总准确率达85%,N分期的阳性准确率达74%。腹腔镜保肛术与开腹手术并发症比较差异无统计学意义(29%比22%, χ2=0.463,P=0.496)。远、近切端阴性、环周切缘与术前直肠系膜筋膜距离一致,手术层面无癌组织残留,MRI测得的肿瘤下界与肛直角距离与实际肿瘤距齿状线距离相当。全组患者术后均无肿瘤复发。结论高分辨MRI检查有良好的软组织分辨率,对低位直肠癌术前T分期和N分期诊断准确性较高,在手术层面的界定中起决定性作用,能使保肛手术质量和安全性提高,疗效满意。
其他摘要	Objective By comparing preoperative high resolution magnetic resonance imaging (MRI) examination with postoperative pathologic results,to investigate the effects of MRI examination evaluation on the anatomical level and clinical outcome.Methods We conducted a retrospective study on 72 patients who underwent resection of rectal cancer at the Second Affiliated Hospital of Wenzhou Medical University between Apr 2017 and Nov 2018,including 35 patients undergoing laparoscopic resection and 37 patients doing open resection.All cases received high resolution MRI examination before operation.The diagnostic accuracy of MRI,operation safety,and the short-term outcomes were analyzed.Results There were no postoperative tumor recurrence.The accuracy rate of preoperative MRI evaluation of T stage was 85%,and positive N + was 74%.There were no difference in postoperative complications between the open resection group and laparoscopic resection group (29% vs.22%,χ~2 =0.463,P=0.496).The proximal and distal margin was negative,postoperative circumferential resection margin and preoperative mesorectal fascia was consistent,the distance between the lower margin of the tumor and the anal right angle measured by MRI were consistent with the distance between the tumor from the dentate line.Conclusion High resolution MRI with a good tissue resolution,has a high preoperative diagnosis accuracy for T and N staging of the low rectal cancer,with decisive role in the evaluation on the anatomical level,improving the quality and safy of surgery.
资助项目	温州市科技局科技计划项目（Y20170102）
ISSN	1007-631X
卷号	35 期号:08 页码:616-619
DOI	10.3760/cma.j.cn113855-20200321-00230
页数	4
收录类别	CNKI ; 万方 ; 维普 ; 北大核心 ; ISTIC ; CSCD ; PKU
学科领域	医药、卫生
URL	查看原文
CSCD记录号	CSCD:6792057
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/25572
专题	附属第二医院第二临床医学院，附属第二医院、育英儿童医院_外科学_肛肠外科
作者单位	1.温州医科大学附属第二医院放射影像科; 2.温州医科大学附属第二医院肛肠外科
推荐引用方式 GB/T 7714	陈邦飞(),杨超颖,金纯,等. 高分辨MRI评估对低位直肠癌保肛手术中的意义及其疗效的影响[J]. 中华普通外科杂志,2020,35(08):616-619.
APA	陈邦飞, 杨超颖, 金纯, & 周崇俊. (2020). 高分辨MRI评估对低位直肠癌保肛手术中的意义及其疗效的影响. 中华普通外科杂志, 35(08), 616-619.
MLA	陈邦飞,et al."高分辨MRI评估对低位直肠癌保肛手术中的意义及其疗效的影响".中华普通外科杂志 35.08(2020):616-619.