活性炭微粒子在胃癌淋巴结清除中的应用研究

Applied study of activated carbon particles to guide gastric cancer lymphadenectomy

目的:探讨活性炭微粒子在胃癌根治术中对淋巴结清除的应用价值。方法:将53例胃癌患者分为2组:实验组16例,术中于癌周浆膜下及淋巴结内注入活性炭微粒子,以被活性炭染黑的淋巴结作为清除标志,行胃癌根治术;对照组37例,行常规胃癌根治术。而后对2组清除的淋巴结及发生转移的淋巴结分别进行统计分析。结果:1)实验组清除的淋巴结数(32.7±11.4枚)明显高于对照组(17.0±8.7枚),差异有统计学意义(P<0.05),主要是清除的N2淋巴结数明显增多,实验组和对照组分别为23.1±8.0枚和8.7±4.2枚;2)实验组黑染淋巴结数占清除淋巴结总数的58.2%,其中Nl的黑染度(66.7%)较N2(49.8%)高;3)黑染淋巴结中发生转移的阳性率(20.7%)明显高于实验组中未黑染者(3.7%)以及对照组(15.2%);4)实验组手术时间稍延长,但手术并发症并未增加。结论:肿瘤周围局部注射活性炭微粒子是一种安全、有效、易行的方法,对胃癌淋巴结清除有指导作用。

Objective： To evaluate the applied value of activated carbon particles to guide gastric cancer lymphadenectomy.Methods： Fifty three patients with advanced gastric carcinoma were divided into two groups： 16 cases received activated carbon particles injection as experimental group and the others as control group.In the experimental group,activated carbon particles was injected into the subserosa and the lymph nodes around the tumor during the operation,the black-stained lymph nodes were regarded as marker of the operation.The patients of control group were received radical surgery of gastric cancer.The number of dissected lymph nodes,black-stained lymph nodes,positive lymph nodes and the side effects of the procedure were analyzed respectively.Results： 1）The average lymph nodes dissected was higher in experimental group（32.7±11.4） than in control group（17.0±8.7,P0.05）,especially in N2（23.1±8.0）：（8.7±4.2）.2）The total black-stained ratio of lymph node was 58.2%,with N1（66.7%） and N2（49.8%） in experimental group.3）The positive rate of lymph node was higher in black-stained lymph nodes（20.7%） than in unstained lymph nodes of experimental group（3.7%） and control group（15.2%）.4）The average operative time was slightly longer in experimental group than in control group,but no more operative complications happened.Conclusion： Local injection of activated carbon particles around the tumor is a safe,effective,easy procedure to guide gastric cancer lymphadenectomy.