| Objective: To investigate the correlation between the diameter change of superior rectal vein(SRV)and inferior mesenteric vein(IMV)by CT examination and the effect of neoadjuvant therapy for rectal cancer.Methods:The relevant medical records of 40 patients with locally advanced rectal cancer who underwent neoadjuvant therapy in the First Affiliated Hospital of Chongqing Medical University were collected from February 2016 to February 2019 Retrospectively.There were 28 males and12 females,aged from 12 to 75 years,with the age of(55±12)years.All patients underwent Standard laparoscopic radical resection of rectal cancer after neoadjuvant therapy.Observation indicators:(1)MRI examinat-ion;(2)CT examination;(3)surgical situations;(4)pathological results;(5)follow-up:the recovery situation of patients after discharge was calculated through outpatient clinics,and the relevant data was calculated until June 2019.Statistical processing using SPSS 25.0 software.Results:(1)MRI examination: there were 22 patients with positiveextramural vascular invasion(EMVI)and 18 with negative EMVI.(2)CT examination:the diameter of SRV was(3.9±0.9)mm and(3.0±0.6)mm before and after neoadjuvant therapy,showing a significant difference(t =5.75,P<0.05).Subgroup analysis:for the 30 patients with response to neoadjuvant therapy,the diameter of SRV changed significantly after neoadjuvant therapy [(4.1±1.0)mm vs(3.4±0.7)mm,t=6.20,P<0.05];for the 10 patients without response to neoadjuvant therapy,the diameter of SRV showed no significant difference after neoadjuvant treatment[(3.6±0.6)mm vs(3.5±0.8)mm,t=1.13,P>0.05].The diameter of SRV was(4.2±0.8)mm in 22 patients with positive EMVI and(3.7±0.8)mm in 18 patients with negative EMVI,showing a significant difference between the two groups(t=2.45,P<0.05).The diameter of IMV was(5.1±0.9)mm and(4.2±0.9)mm before and after neoadjuvant therapy,showing a significant difference(t = 4.16,P < 0.05).Subgroup analysis:for the 30 patients with response to neoadjuvant therapy,the diameter of IMV changed significantly after neoadjuvant therapy [(5.1±0.9)mm vs(4.6±0.8)mm,t=0.76,P<0.05];for the 10 patients without response to neoadjuvant therapy,the diameter of IMV showed no significant difference after neoadjuvant treatment[(5.0±0.9)mm vs(4.8±1.0)mm,t=0.76,P>0.05].The diameter of IMV was(4.8±0.9)mm in 22 patients with positive EMVI and(4.6±0.8)mm in 18 patients with negative EMVI,there is no significant difference between the two groups(t=2.45,P > 0.05).(3)Surgical situations: 40 patients underwent radical resection of rectal cancer,including 4 patients were with synchronous liver metastases undergoing resection of metastases.One of 40 patients with perineal incision infection was improved and discharged after dressing change.1patient with anastomotic leakage on the fifth day after operation was improved and discharged after conservative treatment,other 38 patients were discharged and no obvious abnormality occured during hospitalization.(4)Pathological results : Among the 40 patients,pathological grade of tumor regression(p TRG)was 0 in 7 cases,1 in 10 cases,2 in 13 cases,and3 in 10 cases.(5)Follow-up : 40 patients were followed up for 3.0-6.0months,with a median follow-up time was 4.5 months.One of 40 patients with perineal incision infection was improved and discharged after dressing change.1 patient with anastomotic leakage on the fifth day after operation was improved and discharged after conservative treatment.1 of 2 Two with adhesive intestinal obstruction was improved after surgery and 1 was improved after conservative treatment,other 38 patients were discharged and no obvious abnormality occured during the follow-up.Conclusion: The diameters of SRV and IMV in patients with locally advanced rectal cancer can be decreased significantly after neoadjuvant therapy.The diameter of SRV and IMV can be used as potential indeces to evaluate the effect of neoadjuvant therapy for rectal cancer,and the SRV had a higher evaluation value. |
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