动脉血管入路法在直肠癌淋巴结分检中的价值

The advantage of artery approach in lymph node sorting of rectal cancer

目的探讨动脉血管入路法在直肠癌淋巴结分检中的技术优势。方法选择2015年7月至2016年1月在河南省肿瘤医院普外科住院的60例直肠癌患者，数字表法随机分为血管入路组（观察组）和传统方法组（对照组），对照两组检出淋巴结总数、平均检出淋巴结数、淋巴结〈12枚人数、阳性淋巴结数、淋巴结阳性率、患者转移率、平均直径〈5 mm数、平均直径〈5 mm阳性淋巴结数、第1、2、3站淋巴结数和淋巴结分检时间等指标。结果观察组检出淋巴结总数和阳性淋巴结总数均高于对照组（553∶395，96∶54）；平均检出淋巴结数[（18.43±5.93）个∶（13.27±1.96）个，P＝0.000]、淋巴结分检时间[（14.1±2.5） min∶（17.4±3.2）min，P＝0.000]、平均直径〈5 mm数（4.73±1.31）∶（1.23±1.14），P＝0.000）、平均直径〈5 mm阳性淋巴结（0.97±1.03）∶（0.20±0.55）个，（P＝0.010）、第一站淋巴结[（8.17±4.58）个∶（5.07±1.96）个，P＝0.000]和第二站淋巴结数[（6.57±1.87）个∶（4.90±1.69）个，P＝0.001]等指标差异均有统计学意义有。淋巴结〈12枚人数、淋巴结阳性率、患者转移率和第三站淋巴结数等差异均无统计学意义（均P≥0.05）。结论采用动脉血管入路方法在直肠癌淋巴结分检中具有操作简便，获取淋巴结数目多，更有利于准确病理分期等优点。

Objective To explore the technical advantages of artery approach in lymph node sortingofrectal cancer. Methods Sixty patients with rectal cancer who treated in general surgery department of Henan provincial tumor hospitalfrom July 2015 to January 2016 were enrolled. Patientswere divided into two groupsrandomly. Lymph node sorting methods of control group andobservation group were the traditional method and the artery approach method respectively. The total number of lymph nodes, the average inspection number, the patients number of lymph nodes less than 12, the number of positive lymph nodes, the metastasis rate of the patients, the number of average diameter less than 5 mm, the number of the positive lymph nodes which average diameter less than 5 mm, the sorting time of lymph nodes, the total number of every stationand other indicators were collected and compared. Results There wasa significant difference between the observation group and the control groupin the total number（553 vs 395, P 〈 0. 05 ） , the number of positive ones （ 96 vs 54, P 〈 0. 05 ）, average inspection number （ 18.43 ± 5.93 vs 13.27 ± 1.96, P = 0. 000）, the sorting time （miu） （ 14.1 ± 2. 5 vs 17.4 ± 3.2, P = 0.000 ）, the average diameter less than 5 mm number（4. 73 ± 1.31 vs 1.23 ± 1.14, P = 0. 000）, the number of positive ones average diameter less than 5 mm（0. 97 ± 1.03 vs 0. 20 ±0. 55, P =0. 010） ,the first（8. 17 ±4. 58 vs 5.07 ± 1.96, P = 0. 000） and second station （6. 57 ± 1.87 vs 4. 90 ± 1.69, P = 0. 001 ） inspection number. The inspection number less than 12, the positive rate of lymph node, the metastatic rate of the patient and the inspection number of third station have no significant differences （all P ≥ 0. 05 ）. Conclusion Theartery approach method inrectal cancer lymph node inspectionhas many advantages such as simple operation, obtaining more lymph nodes and more accurate pathological staging.