纳米炭示踪剂在腹腔镜辅助近端进展期胃癌根治术中应用

Application of the nanocarbon tracer assisted by laparoscopy in radical gastrectomy of advanced proximal gastric cancer

目的:比较在腹腔镜下近端进展期胃癌根治术中应用纳米炭示踪剂的优势与不足,探讨纳米炭示踪剂应用的可行性。方法:选取接受纳米炭引导下腹腔镜辅助近端进展期胃癌根治术治疗的病人40例(纳米炭组),并选择同时期未用纳米炭示踪剂的病人40例(对照组),比较2组病人手术时间、术中出血量、术后排气时间、术后住院时间、术后并发症、清扫淋巴结数目、淋巴结黑染数目、淋巴结转移数目、<5 mm淋巴结数目、淋巴结直径等指标。结果:2组在手术时间、术中出血量、术后排气时间、术后住院时间、围手术期并发症发生率差异均无统计学意义(P>0.05)。纳米炭组在淋巴结平均检获数、黑染淋巴结转移率、直径<5 mm淋巴结数、最小淋巴结直径均高于对照组(P<0.01),纳米炭组黑染淋巴结转移率高于未黑染淋巴结转移率(P<0.01)。结论:在腹腔镜辅助近端进展期胃癌根治术中,纳米炭淋巴示踪剂安全有效,可提高淋巴结检出数目及淋巴结转移率。

Objective：To compare the advantages and disadvantages of the application of nanocarbon tracer assisted by laparoscopy in radical gastrectomy of advanced proximal gastric cancer,and explore the feasibility of the nanocarbon tracer application.Methods：Fourty advanced proximal gastric cancer patients treated with nanocarbon tracer assisted by laparoscopy and 40 patients treated without nanocarbon tracer were divdived into the nanocarbon group and control group,respectively.The operation time,peroperative bleeding,postoperative exhaust time and hospital stay,postoperative complications,number of the dissecting,black-dyed and metastasis of lymph nodes,and number of lymph nodes with less than 5 mm in diameter between two groups were compared.Results：There were not significant differences in the operation time,intraoperative blood loss,postoperative exhaust time and hospital stay,and incidence rate of postoperative complications between two groups（P〉0.05）.The average number of the positive lymph nodes,metastasis rate of the black-dyed lymph nodes,number of lymph nodes with less than 5 mm in diameter,and minimum diameter of lymph nodes in nanocarbon group were significantly higher than those in control group（P〈0.01）.The metastasis rate of the black-dyed lymph nodes was higher than that of nonblack-dyed lymph nodes in nanocarbon group（P〈0.01）.Conclusions：In the radical gastrectomy of advanced proximal gastric cancer assisted by laparoscopy,the nanocarbon tracer is safe and effective,which can enhance the detecting number of lymph nodes and metastasis rate of lymph nodes.