无需内镜下纹身的腹腔镜结直肠癌切除术的肿瘤定位
Tumor Localization for Laparoscopic Colorectal Resection Without Endoscopic Tattooing.
作者信息
Cai Zhenghao, Pan Ruijun, Ma Junjun, Zheng Minhua
机构信息
*Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine †Shanghai Minimally Invasive Surgery Center, Shanghai, P.R. China.
出版信息
Surg Laparosc Endosc Percutan Tech. 2016 Jun;26(3):230-5. doi: 10.1097/SLE.0000000000000257.
INTRODUCTION
Tumor localization is a key step in laparoscopic colorectal surgery. Endoscopic tattooing is widely practiced with a satisfactory accuracy, whereas few studies have investigated its shortcomings. The aim of our study is to assess the accuracy and efficiency of a tumor localization protocol without endoscopic tattooing.
METHODS
The tumor localization protocol was performed for 788 colorectal cancer/polyp patients undergoing laparoscopic colorectal resection. The localization accuracy was evaluated by the intraoperative exploration and the anatomopathologic results.
RESULTS
The localization accuracy was 100% in our study. The drawbacks of endoscopic tattooing were overcome. Only 16.6% of the patients underwent preoperative endoscopic clip placement. Intraoperative colonoscopy was performed as a planned and purposive procedure instead of a remedial measurement. The misplacement of the camera port for laparoscopy was avoided in 18 cases (2.3%) guided by this protocol.
CONCLUSIONS
Colorectal tumor localization could be improved by this tumor localization protocol without endoscopic tattooing.
引言
肿瘤定位是腹腔镜结直肠手术的关键步骤。内镜下纹身术应用广泛，准确性令人满意，但很少有研究探讨其缺点。我们研究的目的是评估一种无内镜纹身术的肿瘤定位方案的准确性和效率。
方法
对788例行腹腔镜结直肠切除术的结直肠癌/息肉患者实施肿瘤定位方案。通过术中探查和解剖病理结果评估定位准确性。
结果
本研究中定位准确率为100%。克服了内镜纹身术的缺点。仅16.6%的患者术前行内镜下夹子放置。术中结肠镜检查作为一种有计划、有目的的操作进行，而非补救措施。在此方案指导下，18例（2.3%）避免了腹腔镜摄像头端口的误置。
结论
这种无内镜纹身术的肿瘤定位方案可提高结直肠肿瘤定位水平。
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