術前經直腸超聲評估直腸癌手術方案的隨機對照試驗_《中國循證醫學雜志》

作者：

汪曉東 ¹ , 呂東昊 ¹ , 崔貝貝 ¹ , 時瑩瑜 ² , 何帆 ¹ , 李立 ¹

1. 四川大學華西醫院肛腸外科（成都 610041）；2. 四川大學華西醫院超聲診斷科（成都 610041）;

關鍵詞：

直腸腫瘤外科手術經直腸超聲手術前評估隨機對照試驗

DOI：

10.7507/1672-2531.20080231

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目的　探討經直腸超聲（transrectal ultrasound，TRUS）術前評估對直腸癌手術方案選擇的影響。
方法　納入病理診斷為直腸癌且腫瘤下緣距齒狀線≤ 10 cm者110例，將患者根據電腦產生的隨機序列隨機分為A組和B組，每組各55例。A 組患者術前行TRUS評估分期和Clinical Stage System（CS分期），B 組患者術前只行CS分期。記錄術前TRUS分期、CS分期和預計手術方案，與術后病理分期和實際手術方案進行比較。
結果　本研究納入研究病例99例，A組49例，B組50例，兩組基線差異無統計學意義。A 組行TRUS分期的準確度為91.8%，B組行CS分期的準確度為48.0%，二者差異有統計學意義（P=0.000）。A 組術前預測手術方案的準確度為93.9%，B組為76.0%，二者差異也有統計學意義（P=0.013）。
結論　 TRUS評估直腸癌術前分期的準確性明顯高于CS分期，運用TRUS進行術前評估可以使術前預估直腸癌手術方案的準確性明顯提高，TRUS在直腸癌術前評估中具有較高的臨床應用價值。

引用本文： 汪曉東,呂東昊,崔貝貝,時瑩瑜,何帆,李立. 術前經直腸超聲評估直腸癌手術方案的隨機對照試驗. 中國循證醫學雜志, 2008, 08(12): 1043-1046. doi: 10.7507/1672-2531.20080231 復制

1.	Rafaelsen SR, S?rensen 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.	汪曉東, 李立. 結直腸腫瘤多學科協作診治模式下整體構建理念及基本組織構架. 中國普外基礎與臨床雜志, 2007, 14(3): 339-334.

1. Rafaelsen SR, S?rensen 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. 汪曉東, 李立. 結直腸腫瘤多學科協作診治模式下整體構建理念及基本組織構架. 中國普外基礎與臨床雜志, 2007, 14(3): 339-334.

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術前經直腸超聲評估直腸癌手術方案的隨機對照試驗

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《中國循證醫學雜志》

術前經直腸超聲評估直腸癌手術方案的隨機對照試驗

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