用印度墨水和微线圈在 CT 引导下精确标记直肠癌侧淋巴结复发的腹腔镜切除术:病例报告

Shunsuke Furukawa, Masatsugu Hiraki, Takeshi Oda, Yukihiko Takahashi, Ryuichirou Samejima
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引用次数: 0

摘要

虽然在腹腔镜手术中很少使用,但计算机断层扫描(CT)引导下的标记对于定位小病灶非常有用。本研究描述了腹腔镜切除术术前CT引导标记治疗直肠癌侧淋巴结复发的效果。一名 48 岁的男性因直肠癌(术后诊断为 IIIb 期)接受了腹腔镜低位前切除术和 D3 淋巴结清扫术。术后进行了辅助化疗。6 个月后,在左外侧区域观察到淋巴结复发。全身化疗缩小了转移淋巴结的大小,但术后 3.5 年,淋巴结直径又增大了 10 毫米,因此计划进行腹腔镜切除术。由于靶病灶较小,且位于盆腔深处,因此术前在CT引导下进行了印度墨水注射标记和栓塞微线圈植入术。标记被清晰地识别出来,病灶被成功切除,并留有足够的边缘。因此,本研究中描述的方法被认为可用于检测小病灶。
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Precision CT‑guided marking with India ink and microcoils for laparoscopic resection of a lateral lymph node recurrence of rectal cancer: A case report
Although rarely used in laparoscopic surgery, computed tomography (CT)-guided marking is useful for targeting small lesions. The present study describes the performance of laparoscopic resection with preoperative CT-guided marking for lateral lymph node recurrence of rectal cancer. A 48-year-old man underwent laparoscopic low anterior resection with D3 lymph node dissection for rectal cancer (postoperative diagnosis, stage IIIb). Postoperative adjuvant chemotherapy was then administered. Solitary lymph node recurrence was observed in the left lateral region after 6 months. Systemic chemotherapy reduced the size of the metastatic lymph nodes; however, 3.5 years after the surgery, the diameter increased by 10 mm, and laparoscopic resection was thus planned. Because the target lesion was small and located deep in the pelvis, preoperative CT-guided marking was performed with India ink injection and embolization microcoil implantation. The markers were clearly identified and the lesion was successfully resected with adequate margins. The approach described in the present study is thus considered potentially useful for the detection of small lesions.
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