微粒子活性炭在胃癌淋巴结清扫术中的应用价值

Assessment of activated carbon in standard lymphadenectomy in gastric cancer

目的探讨在胃癌淋巴清扫术中使用微粒子活性炭的手术效果。方法对 87例患者肿瘤局部注射微粒子活性炭混悬液标记区域淋巴结后行胃大部切除术或全胃切除术 ,以 1997年以前183例行常规胃癌根治术患者作为对照组。结果胃大部切除术中 ,活性炭组D1、D2 、D3 和D3 +PAL(腹主动脉旁 )术式占总例数的比例分别为 4 7%、10 3%、14 9%和 16 1% ,而对照组分别为 2 5 7%、2 1 3%、9 9%和 2 7% ;全胃切除术中 ,活性炭组D1、D2 、D3 和D3 +PAL术式的比例分别为 3 4 %、5 7%、2 1 9%和 2 3 0 % ,而对照组分别为 15 8%、14 8%、8 7%和 1 1% ;2组 4种术式在胃大部切除术和全胃切除术中差异均有显著意义。活性炭组平均每例切除的淋巴结数量明显多于对照组。 2组的并发症和病死率之间差异无显著意义。结论微粒子活性炭肿瘤局部注射是一种简单、易行和安全的方法 ,对标准胃癌根治术有一定的辅助作用。

ObjectiveTo assess activated carbon in the standard lymphadenectomy of gastric cancer.Methods183 cases undergoing radical gastrectomy before 1997 served as control group,87 consecutive cases after 1997 received intumour injection of activated carbon(AC) before undergoing gastrectomy.The areas and number of dissected lymph nodes,operative complication and hospital stay in subtotal gastrectomy and total gastrectomy were analyzed respectively.ResultsIn subtotal gastrectomy,the ratio of D 1 ,D 2 ,D 3 and D 3 +PAL over the total cases was 4 7%,10 3%,14 9% and 16 1% respectively in AC group and 25 7%,21 3%,9 9% and 2 7% respectively in control group.In total gastrectomy,the ratio of D 1 ,D 2 ,D 3 and D 3 +PAL was 3 4%,5 7%,21 9% and 23% respectively in AC group and 15 8%,14 8%,8 7% and 1 1% respectively in control group.The differences of the four procedures were all statistically significant between the two groups.The number of dissected lymph nodes in each case in AC group was more than that of control group.ConclusionsLocal injection of activated carbon is a simple,easy and safe method to increase the dissection of lymph nodes in radical gastrectomy.