摘要
目的: 探讨定量CT测量的腹部脂肪分布在腹腔镜直肠癌全手术指导中的临床意义。 方法: 回顾性分析2018年1月至2019年1月我院收治的106例直肠癌患者的临床资料,均于我院行腹腔镜直肠癌根治术,术前均接受CT检查。根据CT定量测量结果,将内脏脂肪面积(VFA)>100cm 2的患者定义为VFA-L组(54例),VFA≦100cm 2的患者定义为VFA-S组(52例)。比较两组患者术中(术中出血量、切口长度、手术时间、中转开腹数、淋巴结清扫数)、术后(术后进食时间、术后排气时间、吸氧时间、术后住院时间、并发症发生率)等指标及系膜完整度差异性。 结果: 两组患者切口长度、术后进食时间、术后排气时间、吸氧时间比较,差异无统计学意义(P>0.05),VFA-L组患者术中出血量大于VFA-S组,手术时间、术后住院时间长于VFA-S组,淋巴结清扫数目少于VFA-S组,中转开腹例数多于VFA-S组,术后并发症发生率高于VFA-S组,系膜完整率低于VFA-S组(P<0.05)。 结论: 患者VFA过高会增加腹腔镜直肠癌根治术的操作难度和风险,增加术后并发症发生的可能性,并延长住院时间,CT定量测定患者腹部脂肪分布对手术难度和风险进行评估,可为手术方式和术前准备提供依据。
Objective: To explore the clinical significance of quantitative CT measurement of abdominal fat distribution in the laparoscopic of total surgery of rectal cancer. Methods: The clinical data of 106 patients with rectal cancer admitted to our hospital from Jan. 2018 to Jan. 2019 were retrospectively analyzed. All patients were given laparoscopic radical resection of rectal cancer and given CT examination before surgery. According to the CT quantitative measurement results, patients with visceral fat area (VFA) > 100 cm2 were defined as VFA-L group (54 cases), and patients with VFA≦100 cm2 were defined as VFA-S group (52 cases). The intraoperative indicators (intraoperative blood loss, incision length, operative time, number of cases of conversion to laparotomy, lymph node dissection quantity) and postoperative indicators (postoperative feeding time, postoperative exhaust time, oxygen inhalation time, postoperative hospital stay, incidence rate of complications) indicators and mesangial integrity were compared between the two groups. Results: There were no significant differences in incision length, postoperative feeding time, postoperative exhaust time and oxygen inhalation time between the two groups (P>0.05), and the intraoperative blood loss in VFA-L group was greater than that in VFA-S group, and the operative time and postoperative hospital stay were longer than those in VFA-S group, and the lymph node dissection quantity was less than that in VFA-S group, and the number of cases of conversion to laparotomy was higher than that in VFA-S group, and the incidence rate of postoperative complications was higher than that in VFA-S group, and the mesangial integrity rate was lower than that in VFA-S group (P<0.05). Conclusions: High VFA in patients will increase the operation difficulty and risk of laparoscopic radical resection of rectal cancer, increase the possibility of postoperative complications and prolong hospital stay. Quantitative CT measurement of abdominal fat distribution can evaluate the operation difficulty and risk and provide a basis for surgical procedures and preoperative preparation.
作者
魏君
贾瑞娟
邱磊
于芬
张少锐
WEI Jun;JIA Ruijuan;QIU Lei(Second People's Hospital of Foshan,Guangding Foshan 528000,China)
出处
《河北医学》
CAS
2020年第1期114-118,共5页
Hebei Medicine
基金
广东省卫生和计划生育局医学科研课题,(编号:20180100)
关键词
直肠癌
腹腔镜手术
内脏脂肪面积
淋巴结清扫
并发症
Rectal cancer
Laparoscopic surgery
Visceral fat area
Lymph node dissection
Complications
