微粒子活性炭在腹腔镜结直肠癌手术中的定位作用

Orientating function of microparticle active carbon in laparoscopic colorectal surgery

目的:探讨微粒子活性炭用于腹腔镜结直肠癌手术中定位的有效性。方法:21例结直肠癌患者,术前常规纤维结肠镜检查找到肿瘤部位,然后让患者取俯卧位,向肿瘤附近肠腔内注入生理盐水,生理盐水滞留处是大肠后侧,水面的正对侧则是大肠的腹腔侧,腹腔侧的大肠粘膜是注射微粒子活性炭的目标位置,先向此处的粘膜下注射生理盐水,形成粘膜膨疹,再向膨疹内注射微粒子活性炭,腹腔镜手术中寻找大肠浆膜黑染位置。结果:21例患者腹腔镜手术中均清晰见到大肠浆膜被微粒子活性炭黑染的标记,并以此为依据确定了手术切除范围,所有病变均行腹腔镜手术切除。结论:在腹腔镜结直肠癌手术前注射微粒子活性炭具有定位作用,此法简单、实用、节省手术时间,具有良好的应用前景。

Objective： To explore the clinical efficacy of preoperative injection of activated carbon in delineation of cancer location in laparoscopic colorectal surgery. Methods： Twenty-one cases with colorectal cancer undergoing laparoscopic surgery were enrolled in the study. All patients were exarnined by colonoscopy with usual preparation one to three days before operation. When the cancer lesions were detected,the patients were set in the prone position, and 20-40ml sodium chloride was iniected into the lumen to form the marking point. First, lrnl saline solution was injected into the submucosal space of that marking point;and then injected 0.3-0.4ml activated carbon into mucosal bulge. Results：The carbon-stained area was clearly recongizable as a blackened patch on the serosal surface of the colon and rectum during laparoscopic surgery. Condusions： The preoperative injection of activated carbon conduces to the intraoperative delineation of coloroctal cancer lesions. It is a simple, practical, time saving technique with rare complications and is recommended for the rapid and accurate delineation of laparoscopic colorectal surgery.