术前 CT 结肠成像在结肠癌中的应用。

Usefulness of preoperative CT colonography for colon cancer.

机构信息

Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan.

出版信息

Asian J Surg. 2017 Nov;40(6):438-443. doi: 10.1016/j.asjsur.2016.04.002. Epub 2016 May 20.

DOI:10.1016/j.asjsur.2016.04.002

PMID:27215142

Abstract

BACKGROUND

Computed tomographic colonography (CTC) is reported to be feasible for screening of colorectal polyps; however, its efficacy in preoperative workup remains unknown. This study was done to define our CTC methodology and assess CTC's potential for preoperative examination in patients with colon cancer.

METHODS

A total of 86 colon cancer patients underwent CTC prior to laparoscopic colectomy in our department from February 2014 to November 2015. The location of primary colon cancer determined by CTC was compared with that confirmed during the surgery. CTC was performed just after preoperative colonoscopy; for a small colon cancer, we performed clipping during colonoscopy to enhance CTC detectability. We classified wall deformities and compared them with the pathological T stage.

RESULTS

CTC accurately located all 87 primary colon cancers prior to surgery. No patient experienced complications associated with CTC. The deformity classification correlated significantly with the pathological T stage (p < 0.001, Kruskal-Wallis nonparametric tests). CTC provided reconstructed images depicting the feeding artery of the primary colon cancer; feeding artery information obtained by CTC facilitated precise lymph node dissection.

CONCLUSION

CTC appears to be a feasible and useful preoperative examination modality for colon cancer treatment.

摘要

背景

计算机断层扫描结肠成像（CTC）被报道可用于结直肠息肉的筛查；然而，其在术前评估中的效果尚不清楚。本研究旨在确定我们的 CTC 方法，并评估 CTC 在结肠癌患者术前检查中的潜力。

方法

2014 年 2 月至 2015 年 11 月，我院 86 例结肠癌患者在腹腔镜结肠切除术前行 CTC。通过 CTC 确定的原发性结肠癌的位置与手术中证实的位置进行比较。CTC 在术前结肠镜检查后立即进行；对于小的结肠癌，我们在结肠镜检查时进行夹闭以提高 CTC 的检测能力。我们对壁变形进行分类，并与病理 T 分期进行比较。