Clinical effects of high resolution magnetic resonance imaging examination on the evaluation for lower rectal cancer undergoing sphincter-preserving operation / 中华普通外科杂志

ABSTRACT

Objective:By comparing preoperative high resolution magnetic resonance imaging (MRI) examination with postoperative pathologic results, to investigate the effects of MRI examination evaluation on the anatomical level and clinical outcome.Methods:We conducted a retrospective study on 72 patients who underwent resection of rectal cancer at the Second Affiliated Hospital of Wenzhou Medical University between Apr 2017 and Nov 2018, including 35 patients undergoing laparoscopic resection and 37 patients doing open resection. All cases received high resolution MRI examination before operation. The diagnostic accuracy of MRI, operation safety, and the short-term outcomes were analyzed.Results:There were no postoperative tumor recurrence. The accuracy rate of preoperative MRI evaluation of T stage was 85%, and positive N+ was 74%. There were no difference in postoperative complications between the open resection group and laparoscopic resection group (29% vs. 22%, χ 2=0.463, P=0.496). The proximal and distal margin was negative, postoperative circumferential resection margin and preoperative mesorectal fascia was consistent, the distance between the lower margin of the tumor and the anal right angle measured by MRI were consistent with the distance between the tumor from the dentate line. Conclusion:High resolution MRI with a good tissue resolution, has a high preoperative diagnosis accuracy for T and N staging of the low rectal cancer, with decisive role in the evaluation on the anatomical level, improving the quality and safy of surgery.