Value Of Three-dimensional CT Reconstruction In Anatomical Resection Of Colon Tumors

Objective To explore the value of abdominal spiral CT angiography(CTA)and three-dimensional imaging of colon before laparoscopic radical resection of colon tumor.Methods To retrospectively analyze the clinical data of patients admitted to the undergraduate department for laparoscopic radical colon cancer surgery from March 2015 to February 2018 and Forty patients who underwent conventional CT scan before operation were selected into control group according to exclusion and inclusion criteria.Forty patients who underwent three-dimensional abdominal imaging before operation were selected into experimental group according to exclusion and inclusion criteria.The data of the two groups,the differences of the related indexes during and after operation,the tumors and the blood supply vessels in the three-dimensional images were compared.Results There were no significant differences in age,sex,BMI value,lesion location and tumor morphology between the two groups(P> 0.05).The operation time of the two groups was(165.90±47.85)min and(192.88±43.16)min,respectively.The operation time of the three-dimensional reconstruction group was significantly shorter than that of the conventional CT group(P=0.010).The intraoperative bleeding volume of the two groups were(87.34±39.68)ml and(121.75±33.42)ml,respectively.The intraoperative bleeding volume of the three-dimensional reconstruction group was significantly less than that of the conventional CT group(P=0.001).The number of abnormal vessels found before operation in three-dimensional reconstruction group and conventional CT group was 9 cases and 0 cases respectively.Comparisons showed that abnormal vessels could be found before operation in three-dimensional reconstruction group,but it was difficult to find abnormal vessels before operation in conventional CT group.There was significant difference between the two groups(P=0.001).The number of anastomotic fistula after operation in the two groups was 2 and 7 respectively.It was found that the number of anastomotic fistula after operation in the three-dimensional imaging group was significantly less than that in the conventional CT group(P=0.030).Postoperative abdominal drainage of the two groups were(61.03±18.82)ml and(73.10±21.16)ml,respectively.It was found that the postoperative abdominal drainage of the three-dimensional imaging group was significantly less than that of the conventional CT group,and the difference was statistically significant(P=0.009).The total hospitalization days of the two groups were(9.41±2.62)days and(11.52±2.02)days,respectively.It wasfound that the total hospitalization days of the three-dimensional imaging group were significantly shorter than those of the conventional CT group(P = 0.046).There was no significant difference between the two groups in the number of total lymph node dissection,histological classification of tumors,pathological stage,time of anal ventilation after operation,incision infection rate after operation and intestinal obstruction after operation(P > 0.05).The three-dimensional fusion image can visually display the panoramic images of abdominal intestinal canal,colon tumors and their blood supply vessels.Conclusion Preoperative abdominal CTA and three-dimensional colon imaging can identify the anatomical location and blood supply vessels of colon tumors.Variant blood vessels can be found before operation.It can effectively shorten the operation time,reduce intraoperative bleeding,reduce total drainage volume,reduce the incidence of anastomotic leakage,and reduce hospitalization days.It has certain value for the anatomical resection of colon tumors.