术前经直肠超声评估直肠癌手术方案的随机对照试验_《中国循证医学杂志》

作者：

汪晓东 ¹ , 吕东昊 ¹ , 崔贝贝 ¹ , 时莹瑜 ² , 何帆 ¹ , 李立 ¹

1. 四川大学华西医院肛肠外科（成都 610041）；2. 四川大学华西医院超声诊断科（成都 610041）;

关键词：

直肠肿瘤外科手术经直肠超声手术前评估随机对照试验

DOI：

10.7507/1672-2531.20080231

视频：

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目的　探讨经直肠超声（transrectal ultrasound，TRUS）术前评估对直肠癌手术方案选择的影响。
方法　纳入病理诊断为直肠癌且肿瘤下缘距齿状线≤ 10 cm者110例，将患者根据电脑产生的随机序列随机分为A组和B组，每组各55例。A 组患者术前行TRUS评估分期和Clinical Stage System（CS分期），B 组患者术前只行CS分期。记录术前TRUS分期、CS分期和预计手术方案，与术后病理分期和实际手术方案进行比较。
结果　本研究纳入研究病例99例，A组49例，B组50例，两组基线差异无统计学意义。A 组行TRUS分期的准确度为91.8%，B组行CS分期的准确度为48.0%，二者差异有统计学意义（P=0.000）。A 组术前预测手术方案的准确度为93.9%，B组为76.0%，二者差异也有统计学意义（P=0.013）。
结论　 TRUS评估直肠癌术前分期的准确性明显高于CS分期，运用TRUS进行术前评估可以使术前预估直肠癌手术方案的准确性明显提高，TRUS在直肠癌术前评估中具有较高的临床应用价值。

引用本文： 汪晓东,吕东昊,崔贝贝,时莹瑜,何帆,李立. 术前经直肠超声评估直肠癌手术方案的随机对照试验. 中国循证医学杂志, 2008, 08(12): 1043-1046. doi: 10.7507/1672-2531.20080231 复制

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9.	Kwok H, Bissett IP, Hill GI. Preoperative staging of rectal cancer. Int J Colorectal Dis, 2000, 15(1): 9-20.
10.	Bipat S, Glas AS, Slors FJ, et al. Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT and MR imaging: a meta-analysis. Radiology, 2004, 232: 773-783.
11.	汪晓东, 李立. 结直肠肿瘤多学科协作诊治模式下整体构建理念及基本组织构架. 中国普外基础与临床杂志, 2007, 14(3): 339-334.

1. Rafaelsen SR, Sørensen T, Jakobsen A, et al. Transrectal ultrasonography and magnetic resonance imaging in the staging of rectal cancer. Effect of experience. Scand J Gastroenterol, 2008, 43(4): 440-446.
2. Gan SI, Rajan E, Adler DG, et al. ASGE Standards of Practice Committee,. Role of EUS. Gastrointest Endosc, 2007, 66(3): 425-434.
3. Tjandra JJ, Kilkenny JW, Buie WD, et al. Practice parameters for the management of rectal cancer (revised). Dis Colon Rectum, 2005, 48(3): 411-423.
4. Engstrom PF, Arnoletti JP, Benson AB, et al. NCCN practice guidelines in oncology. Rectal Cancer, - v.1.2008. www.nccn.org.
5. Davila RE, Rajan E, Adler D, et al. ASGE guideline: the role of endoscopy in the diagnosis, staging, and management of colorectal cancer. Gastrointest Endosc, 2005, 61(1): 1-7.
6. Salerno G, Daniels IR, Fisher SE, et al. A comparison of digital rectal examination versus magnetic resonance imaging in the prediction of circumferential resection margin status in patients. Colorectal Disease, 2005, 7 (Suppl 2): 56.
7. Shirkhoda A, Madrazo BL. Chief editor. Pelvic Ultrasound. USA: Lippincott Williams and Wilkins, 1993, 173-206.
8. Greene FL, Page DL, Fleming ID, et al. AJCC cancer staging manual. 6th ed. New York(NY). Springer-Verlag, 2002, 113-124.
9. Kwok H, Bissett IP, Hill GI. Preoperative staging of rectal cancer. Int J Colorectal Dis, 2000, 15(1): 9-20.
10. Bipat S, Glas AS, Slors FJ, et al. Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT and MR imaging: a meta-analysis. Radiology, 2004, 232: 773-783.
11. 汪晓东, 李立. 结直肠肿瘤多学科协作诊治模式下整体构建理念及基本组织构架. 中国普外基础与临床杂志, 2007, 14(3): 339-334.

《中国循证医学杂志》

术前经直肠超声评估直肠癌手术方案的随机对照试验

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《中国循证医学杂志》

术前经直肠超声评估直肠癌手术方案的随机对照试验

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