摘要
目的探讨胰腺癌术前双源CT血管重建评估对手术可切除性及根治性切除率(R0切除)的影响。方法随机抽取我院2011年1月至2014年12月间行双源CT平扫+增强+血管重建后手术治疗的胰腺癌患者49例,设定为重建组(胰头癌29例,胰体尾癌20例);另随机选取我院2007年1月至2010年12月间行常规CT平扫+增强后手术治疗的55例胰腺癌患者设定为非重建组(胰头癌33例,胰体尾癌22例),分析两组的可切除率(所有入组病例均已排除远端转移和周围脏器浸润);对两组手术切除的患者进一步行R0切除率比较。结果就胰头癌而言,重建组手术切除率和阴性切缘率分别为82.8%(24/29)和87.5%(21/24),均显著高于非重建组63.6%(21/33)和76.2%(16/21)(x^2=22.41和15.73,P=0.001和0.002);对于胰体尾癌,重建组手术切除率和R0切除率分别为90%(18/20)和88.9%(16/18),均显著高于非重建组77.3%(17/22)和76.5%(13/17)(x2=13.1和12.56,P=0.004和0.01)。结论术前双源CT血管重建能够显著提高胰腺癌手术切除率和R0切除率,值得进一步临床推广。
Objective To investigate the significance of preoperative dual source computed tomography（DSCT） vascular-reconstruction on the resectability and radicality of pancreatectomy. Methods In present study,49 pancreatic carcinoma cases received preoperative assessment of dual-source CT plain plus enhanced scan and vascular reconstruction in our hospital between Jan. 2011 and Dec. 2014 were randomly assigned to Reconstruction group（29 cases of pancreatic head carcinoma and 20 cases of pancreatic body and tail cancer）, another 55 pancreatic carcinoma patients received preoperative assessment of conventional 16-slice CT plain plus enhanced scan between Jan. 2007 to Dec. 2010 were randomly assigned to Non-reconstruction group（33 cases of pancreatic head carcinoma and 22 cases of pancreatic body and tail cancer）. The ratios of resectability and consequent negative cut margin proportion were analyzed between two groups. Results For pancreatic head carcinoma, the resectability and negative cut margin proportion in Reconstrction group were 82.8%（24/29） and 87.5%（21/24）, both significantly higher than those in Non-reconstruction group 63.6%（21/33） and 76.2%（16/21）（χ2=22.41 and 15.73, P=0.001 and 0.002）. Similarly results were found in patients with pancreatic body and tail cancer, the resectability and negative cut margin proportion in Reconstruction group were 90%（18/20） and 88.9%（16/18）, which were evidently lower than those in Non-reconstruction group 77.3%（17/22） and 76.5%（13/17）（χ2=13.1 and 12.56, P=0.004 and0.01）. Conclusion Our results demonstrate that preoperative DSCT vascular-reconstruction can effectively improve the resectability and negative cut margin proportion of pancreatectomy, and deserves further application.
出处
《肝胆胰外科杂志》
CAS
2016年第5期378-381,385,共5页
Journal of Hepatopancreatobiliary Surgery
关键词
胰腺癌
双源CT
血管重建
手术可切除性
pancreatic carcinoma
dual-source computed tomography（DSCT）
vascular-reconstruction
resectability
