结肠镜和钡灌肠问世以来,许多术中不能看到或触到的小肿瘤也能发现。因此术前肿瘤的准确定位是很重要的。作者报道6例病人因依靠结肠镜肿瘤定位而误诊、手术失败,需要再次剖腹探查切除肿瘤。虽然内窥镜被认为是诊断肿瘤的金标准,但在肿瘤定位上有问题。依靠长度测量会产生错误。165cm的结肠镜可盘绕在乙状结肠而顶部还没达结肠脾曲,相反有时仅插入60cm结肠镜就可以达盲肠。用内窥镜定位的最好办法是通过确认解剖标志和结构。不幸的是结肠解剖,特别是有肠系膜变异时,可能非常模糊不清。一例结肠镜诊断病变在降结肠,实际上经钡灌肠发现病变在乙状结肠袢的顶部。因此,术前钡灌肠进行准确的肿瘤定位是必要的。当钡灌肠不能发现病变时,如恶性息肉已被内 Since colonoscopy and barium enema were introduced, many small tumors that cannot be seen or touched during surgery can be found. Therefore, accurate positioning of the preoperative tumor is very important. The authors reported that 6 patients were misdiagnosed and failed to operate due to colonoscopic tumor localization. They needed a second laparotomy to remove the tumor. Although endoscopy is considered to be the gold standard for the diagnosis of tumors, there are problems with the positioning of the tumor. Relying on length measurement can produce errors. The 165cm colonoscope can be coiled around the sigmoid colon and does not reach the top of the colon. However, it can sometimes reach the cecum only by inserting a 60cm colonoscope. The best way to use endoscopic positioning is by identifying anatomical landmarks and structures. Unfortunately, colon anatomy, especially with mesenteric variations, can be very vague. A colonoscopy diagnosis of the disease in the descending colon, in fact found by barium enema in the top of the sigmoid fistula. Therefore, preoperative barium enema for accurate tumor localization is necessary. When the barium enema can not find lesions, such as malignant polyps have been