纳米碳示踪技术在直肠癌患者腹腔镜下保留左结肠动脉及清扫第253组淋巴结中的应用

Application of nano-carbon tracer technique in rectal cancer patients undergoing left colon artery reserving and Group 253 lymph node dissection under laparoscopy

目的:探讨纳米碳示踪技术在腹腔镜下保留左结肠动脉时行第253组淋巴结清扫中的应用价值。方法:前瞻性收集2015年8月至2018年7月我院行腹腔镜下直肠癌根治手术患者,随机分为纳米碳示踪和未示踪组,分别统计两组淋巴结清扫数目、第253组淋巴结清扫数目、第253组淋巴结转移率、淋巴结的黑染度、黑染淋巴结的转移率。分析黑染与淋巴结转移的关系,比较两组淋巴结清扫数目。结果:示踪组淋巴结清扫数目为24.6±3.7,第253组淋巴结清扫数目为6.7±1.8,253组淋巴结转移阳性例数为3例;对照组淋巴结清扫数目为18.2±4.3,第253组淋巴结清扫数目为4.2±1.2,253组淋巴结转移阳性例数也为3例。示踪组淋巴结清扫数目和第253组淋巴结清扫数目均明显高于未示踪组,差异有统计学意义。示踪组共清扫淋巴结787枚,黑染淋巴结425枚,黑染度为54.0%。黑染淋巴结阳性数为106例,转移率为24.9%,未黑染的淋巴结转移率为18.7%,二者之间有显著差异。结论:纳米碳标记,有助于提高253组淋巴结检出率,以保证肠系膜下动脉根部淋巴结廓清的彻底性。

Objective:To evaluate the application value of nano-carbon tracer technique in reserving left colon artery and undergoing Group 253 lymph node dissection in patients with rectal cancer under laparoscopy.Methods:Patients with rectal cancer undergoing laparoscopic radical resection from August2015 to July 2018 were randomly divided into two groups:carbon nano-tracer group and non-tracer group.The number of lymph node dissection,the number of lymph node dissection in Group 253,the rate of lymph node metastasis in Group 253,the degree of black staining and the rate of metastasis of black stained lymph node were counted,respectively.The relationship between black staining and lymph node metastasis was analyzed and the number of lymph node dissection was compared between the two groups.Results:In the tracer group,the average number of lymph node dissection was24.6±3.7,the average number of lymph node dissection in Group 253 was 6.7±1.8,and the number of positive cases of lymph node metastasis in Group 253 was 3.In the control gorup,the average number of lymph node dissection was 18.2±4.3,the average number of lymph node dissection in Group 253 was 4.2±1.2,and the number of positive cases of lymph node metastasis in Group 253 was 3.The dissection numbers of total lymph nodes and Group 253 in tracer group were significantly higher than those in non-tracer group.In tracer group,787 lymph nodes and 425 black stained lymph nodes were dissected.The degree of black stain was 54.0%.The positive number of black stained lymph nodes was 106 and the metastasis rate was 24.9%.The unstained lymph node metastasis rate was 18.7%,and there was significant difference between the the control group and the tracer group.Conclusion:Nano-carbon labeling can improve the detection rate of lymph nodes in Group 253 and ensure the clearance of lymph nodes located at the root of submesenteric inferior mesenteric artery.