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术前虚拟结肠镜检查对评估梗阻性结直肠癌患者近端结肠的临床意义

Clinical Significance of Preoperative Virtual Colonoscopy for Evaluation of the Proximal Colon in Patient With Obstructive Colorectal Cancer.

作者信息

Heo Jae-Hyuk, Ryu Chun-Geun, Jung Eun-Joo, Paik Jin-Hee, Hwang Dae-Yong

机构信息

Department of Surgery, Colorectal Cancer Center, Konkuk University Medical Center, Seoul, Korea.

Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.

出版信息

Ann Coloproctol. 2017 Aug;33(4):130-133. doi: 10.3393/ac.2017.33.4.130. Epub 2017 Aug 31.

Abstract

PURPOSE

Virtual colonoscopy is the most recently developed tool for detecting colorectal cancers and polyps, but its effectiveness is limited. In our study, we compared the result of preoperative virtual colonoscopy to result of preoperative and postoperative colonoscopy. We evaluated also the accuracy of preoperative virtual colonoscopy in patients who had obstructive colorectal cancer that did not allow passage of a colonoscope.

METHODS

A total of 164 patients who had undergone preoperative virtual colonoscopy and curative surgery after the diagnosis of a colorectal adenocarcinoma between November 2008 and August 2013 were pooled. We compared the result of conventional colonoscopy with that of virtual colonoscopy in the nonobstructive group and the results of preoperative virtual colonoscopy with that of postoperative colonoscopy performed at 6 months after surgery in the obstructive group.

RESULTS

Of the 164 patients, 108 were male and 56 were female patients. The mean age was 62.7 years. The average sensitivity, specificity, and accuracy of virtual colonoscopy for all patients were 31.0%, 67.2%, and 43.8%, respectively. In the nonobstructive group, the average sensitivity, specificity, and accuracy were 36.6%, 66.2%, and 48.0%, respectively, whereas in the obstructive group, they were 2%, 72.4%, and 25.4%. Synchronous cancer was detected via virtual colonoscopy in 4 of the 164 patients.

CONCLUSION

Virtual colonoscopy may not be an effective method for the detection of proximal colon polyps, but it can be helpful in determining the therapeutic plan when its results are correlated with the results of other studies.

摘要

目的

虚拟结肠镜检查是检测结直肠癌和息肉的最新工具,但其有效性有限。在我们的研究中,我们将术前虚拟结肠镜检查结果与术前及术后结肠镜检查结果进行了比较。我们还评估了术前虚拟结肠镜检查对患有阻塞性结直肠癌且无法通过结肠镜的患者的准确性。

方法

汇总了2008年11月至2013年8月期间164例经诊断为结直肠腺癌后接受术前虚拟结肠镜检查及根治性手术的患者。我们比较了非阻塞性组中传统结肠镜检查结果与虚拟结肠镜检查结果,以及阻塞性组中术前虚拟结肠镜检查结果与术后6个月进行的结肠镜检查结果。

结果

164例患者中,男性108例,女性56例。平均年龄为62.7岁。所有患者虚拟结肠镜检查的平均敏感性、特异性和准确性分别为31.0%、67.2%和43.8%。在非阻塞性组中,平均敏感性、特异性和准确性分别为36.6%、66.2%和48.0%,而在阻塞性组中分别为2%、72.4%和25.4%。164例患者中有4例通过虚拟结肠镜检查发现了同步癌。

结论

虚拟结肠镜检查可能不是检测近端结肠息肉的有效方法,但当将其结果与其他研究结果相关联时,它有助于确定治疗方案。

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