摘要
目的探讨纳米碳示踪剂在胰头部肿瘤行精准胰十二指肠切除术中的应用。方法选取临沂市中心医院普外二科2016年3月~2017年12月收治的65例胰头癌患者为研究对象,按随机数字表法随机分为实验组与对照组。实验组32例,男17例,女15例,年龄33~71岁,将纳米碳混悬液注入胰头部上、中、下三个部位,进行淋巴示踪。对照组33例,男18例,女15例,年龄35~72岁,未应用纳米碳示踪技术。术后对切除标本中淋巴结检出数量、被纳米碳黑染的淋巴结数量、淋巴结超过15枚病例数量、直径小于3mm的微小淋巴结数量、癌转移淋巴结数量、癌转黑染移淋巴结数量,进行比较分析。结果所有65例胰头恶性肿瘤患者均完成全胰腺系膜切除的胰十二指肠切除术,并进行标准淋巴结清扫,术后病理均证实为胰头部恶性肿瘤。两组术后标本共检出淋巴结1009,其中实验组(18.16±3.05)枚/例、对照组(12.97±4.71)枚/例,P<0.01。实验组检出微小淋巴结124枚,对照组检出微小淋巴结67枚。实验组检出淋巴结转移率与对照组比较无明显差异,P>0.05。实验组检出黑染淋巴结352枚,其中癌转移淋巴结71枚,未黑染淋巴结229枚,其中癌转移淋巴结27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。结论纳米碳示踪技术在术中指导手术医师精准清除区域淋巴结,提高了术后切除标本中淋巴结的检出数量,特别是微小淋巴结的检出数量,提高了胰头癌病理分期的准确性。
Objective To investigate the application of carbon nanoparticles technology on accurate pancreatoduodenectomy in pancreatic head cancer.Methods 65 cases with pancreatic head cancer patients who were treated in Linyin Centrol Hosptial from March 2016 to December 2017 were randomly divided into experimental group(32 cases)and control group(33 cases),For the experimental group,32 patients,carbon nanoparticles was injected at 3 locations in pancreatic head,and for the control group,32 patients,without carbon nanoparticles.After operation,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 1009 pieces of lymph node seized in two groups toally,including(18.16±3.05)medals in carbon nanoparticles group and(12.97±4.71)medals in control group.Lymph node number in carbon nanoparticles group was more than control group(P<0.01).carbon nanoparticles group seized 124 tiny lymph nodes,significantly higher than 67 in the control group(P<0.05).The metastasis rate of lymph node was no significant difference in the two groups(P>0.05).carbon nanoparticles group seized lymph node metastasis was no significant difference in the rate of the control group(P>0.05).carbon nanoparticles group seized 352 black dyed lymph nodes and 229 not black dye lymph nodes.And 71 cases of metastasis lymph nodes in Black dye lymph nodes,27cases of metastasis lymph nodes in not the black dye lymph nodes.The metastasis rate of black dye lymph node was higher(P<0.01).Conclusion Carbon nanoparticles technology 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 pancreatic head cancer radical seized quantity.carbon nanoparticles technique can ensure the accuracy of the pathological staging,there was important clinical significance to lymph node dissection in pancreat
作者
刘成彪
崔世昌
王维山
孙启栋
LIU Cheng-biao;CUI Shi-chang;WANG wei-shan;SUN Qi-dong(Second Department of General Surgery,Linyin Centrol Hosptial,Linyi 276400,China)
出处
《山东医学高等专科学校学报》
2018年第1期40-44,共5页
Journal of Shandong Medical College
基金
临沂市科技发展计划项目(201616031
2017ZK004)
关键词
纳米碳示踪技术
精准胰十二指肠切除术
胰头癌
淋巴结清扫
Carbon nanoparticles technology
Accurate pancreatoduodenectomy
Pancreatic head cancer
Lymph node dissection
