Mortensen M B, Fristrup C W, Ainsworth A P, Pless T, Nielsen H O, Hovendal C
Department of Surgical Gastroenterology, Centre for Surgical Ultrasound, Odense University Hospital, DK-5000 Odense C, Denmark.
Br J Surg. 2006 Jun;93(6):720-5. doi: 10.1002/bjs.5342.
This study evaluated the ability of combined endoscopic and laparoscopic ultrasonography to predict R0 resection and avoid unnecessary surgery in patients with upper gastrointestinal tract cancer (UGIC).
A total of 411 consecutive patients with UGIC (182 pancreatic cancers, 134 gastric cancers and 95 oesophageal cancers) treated between January 2002 and May 2004 were analysed prospectively. The allocation of patients into resectability groups by endoscopic ultrasonography (EUS) and laparoscopic ultrasonography (LUS) was compared with the treatment actually undertaken.
The combination of EUS and LUS correctly predicted R0 resection in 90.6 per cent, R1-R2 in 91 per cent and irresectability in 91.4 per cent of patients. Ten patients (2.4 per cent) had explorative laparotomy only. There were no complications associated with the EUS and LUS procedures.
The routine use of EUS and LUS before surgery predicted R0 resection in nine of ten patients and reduced the number of unnecessary laparotomies to less than 3 per cent.
本研究评估了联合内镜超声和腹腔镜超声预测上消化道癌（UGIC）患者R0切除及避免不必要手术的能力。
对2002年1月至2004年5月间连续治疗的411例UGIC患者（182例胰腺癌、134例胃癌和95例食管癌）进行前瞻性分析。将通过内镜超声（EUS）和腹腔镜超声（LUS）对患者进行可切除性分组的情况与实际进行的治疗进行比较。
EUS和LUS联合应用能正确预测90.6%的患者可进行R0切除，91%的患者为R1 - R2切除，91.4%的患者不可切除。10例患者（2.4%）仅接受了探查性剖腹手术。EUS和LUS操作未出现相关并发症。
术前常规使用EUS和LUS能在十分之九的患者中预测R0切除，并将不必要剖腹手术的数量减少至不到3%。
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