在直肠癌手术中尿道损伤:使用尸体解剖,成像分析和临床系列的综合研究
Pere Planellas1,2,3, Lídia Cornejo3, Aram Ehsan4
1Department of General and Digestive Surgery, University Hospital of Girona, 17007 Girona, Spain.
Cancers
|October 28, 2023
概括
了解男性尿道解剖学是预防直肠癌手术期间受伤的关键. 直肠和尿道之间的关键距离对于手术规划和减少并发症至关重要.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术解剖学手术解剖学
- 在瘤学瘤学.
背景情况:
- 在直肠癌手术期间,男性尿道受伤是一种罕见但显著的并发症.
- 关于男性尿道和周围的骨盆结构之间的精确解剖关系的数据有限.
研究的目的:
- 划出男性尿道与直肠和门边缘的解剖关系.
- 为手术规划提供关键测量,以尽量减少直肠癌手术期间尿道损伤.
主要方法:
- 这是一种多方面的方法,结合了尸体解剖,磁共振成像 (MRI) 扫描的回顾性分析和临床病例的审查.
- 关键测量包括直肠道距离 (R-Mu) 和从前直肠壁到门边缘 (R-Am) 的距离.
- 分析了2016年1月至2023年1月期间接受直肠癌手术的244名男性患者的临床数据.
主要成果:
- 尿道损伤的总体发病率很低 (0.73%),但在距离门边缘<10厘米的瘤中显著增加 (4%为腹腔切除,3.2%为TaTME).
- 术前MRI中位数R-Mu距离为1厘米 (范围为0.2-2.3厘米),中位数R-Am距离为4.3厘米 (范围为2-7.3厘米).
- 尸体解剖显示平均R-Mu为1.18厘米,平均R-Am为2.64厘米.
结论:
- 在直肠手术期间,潜在的尿道损伤的关键区域距离门边缘在2 - 7.3厘米以内,与狭窄的直肠腔空间 (0.2 - 2.3厘米) 相比.
- 通过外科医生,解剖学家和放射学家之间的合作,增强解剖学知识对于预防尿道损伤至关重要.
- 精确了解这些解剖学距离可以指导外科手术技术并改善患者的治疗结果.
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