摘要
目的:探讨纳米炭淋巴示踪技术在腹腔镜中低位直肠癌根治术中淋巴结个体化清除的应用价值。方法:52例中低位直肠癌患者随机分为实验组和对照组。实验组术前行肠粘膜下注射纳米炭混悬注射液。对照组与实验组行相同手术,实验组对TME以外的染色淋巴结行个体化清除。术后对两组检获的淋巴结总数、微小淋巴结数目、黑染淋巴结数目、术后病理证实癌转移淋巴结数目情况进行统计学分析。结果:两组共检获淋巴结905枚,其中实验组平均(20.67±5.751)枚/例,对照组(13.88±4.466)枚/例,P<0.01。实验组检获微小淋巴结113枚,其中个体化清除淋巴结26枚,对照组检获微小淋巴结49枚,P<0.05。实验组检获淋巴结癌转移率与对照组无明显差异,P>0.05。实验组检获黑染淋巴结341枚,其中癌转移淋巴结67枚,未黑染淋巴结217枚,其中癌转移淋巴结15枚,黑染淋巴结癌转移率明显高于未黑染淋巴结癌转移率,P<0.01。结论:纳米炭示踪剂能在术中指导手术医师精准清除区域淋巴结,提高淋巴结检出数量,进而提高直肠癌病理分期的准确性,在中低位直肠癌淋巴结清除中有着重要的临床意义,为术后辅助治疗方案的制定提供重要依据。
Objective： To investigate the clinical application value of nano-carbon tracer tech- nology in lymph node dissection and postoperative pathological examination in laparoscopic mid-low rectal cancer resection. Methods- Fifty-two patients with mid-low rectal cancer were randomly divided into experimental group （n=27） and control group （n=25）. Before surgery, the Nano-group were injected nano activated carbon suspension liquid under the mucosa. Both groups were accept- ed the same principles of open colorectal cancer radical surgery. The total number of lymph nodes, number of tiny lymph nodes, number of black dye and number of metastasis lymph node confirmed by pathology in the two groups were statistical analysised. Results： There were 905 pieces of lymph node seized in two groups toally, including （20.67±5.751） medals in Nano-carbon group and （13.88±4.466） medals in control group. Lymph node number in nano carbon group was more than control group （P〈0.01）. Nano-carbon group seized 113 tiny lymph nodes, significantly higher than 49 in the control group （P〈0.05）. The metastasis rate of lymph node was no significant difference in the two groups （P〉0.05）. Nano-carbon group seized lymph node metastasis was no significant dif- ference in the rate of the control group （P〉0.05）. Nano-carbon group seized 341 black dyed lymph nodes and 217 not black dye lymph nodes. And 67 cases of metastasis lymph nodes in Black dye lymph nodes, 15 cases of metastasis lymph nodes in not the black dye lymph nodes. The metastasis rate of black dye lymph node was higher（P〈0.01）. Conclusions： Nano-carbon tracer technique can guide the surgeon to accurately lymph nodes dissection during the operation, and can add to the number of lymph nodes in the postoperative surgical specimens, improve lymph nodes in patients with colorectal cancer radical seized quantity. Nano-carbon tracer technique can ensure the accuracy of the pathological staging, there was important clinical significance to lymph
出处
《中国现代普通外科进展》
CAS
2017年第3期188-192,共5页
Chinese Journal of Current Advances in General Surgery
关键词
纳米炭
腹腔镜
直肠癌
淋巴结清除
Carbon nanoparticles.Tracer technique, Rectal cancer, Lymph node dissection
