达芬奇机器人辅助联合纳米碳在进展期胃癌根治术中的应用

Da Vinci robot assisted radical gastrectomy with carbon nanoparticle lymph node dyeing foradvanced gastric cancer

目的探讨达芬奇机器人辅助联合纳米碳淋巴示踪剂在进展期胃癌根治术中的应用价值。方法回顾性分析2016年6至12月期间甘肃省人民医院收治的63例进展期远端胃癌患者的临床资料，分为达芬奇＋纳米碳组20例，腹腔镜＋纳米碳组24例，腹腔镜组（无术中淋巴结示踪）19例，对3组患者的淋巴结检出情况、术后并发症进行比较。结果达芬奇＋纳米碳组检出淋巴结数为（31．5±3．8）彬例，高于腹腔镜＋纳米碳组的（25．3±2．6）桫例（F=5．5，P=0．03）和腹腔镜组的（21．1±2．7）枚／例（F=6．1，P=0．01）；达芬奇＋纳米碳组检出淋巴结中黑染481枚（76．2％），黑染淋巴结组的肿瘤阳性率为26．8％，与腹腔镜＋纳米碳组（21．6％）和腹腔镜组（18．3％）相比差异无统计学意义（x2=0．17，P=0．22）。术后3组吻合口或残端瘘、术后出血发生率、淋巴瘘发生率、术后平均住院时间、术后首次经肛门排气时间相比差异均无统计学意义（均P〉0．05）。结论达芬奇联合纳米碳在进展期胃癌根治术淋巴结清扫中具有良好的淋巴结示踪效果。

Objective To investigate the application value of carbon nanoparticle lymphatic tracer in Da Vinci robot-assisted radical gastrectomy for advanced gastric cancer. Methods The clinical data of 63 advanced gastric cancer patients in Gansu Provincal Hospital in 2016 were analyzed retrospective｜y. Patients were divided into three groups： robot with carbon nanoparticle group, laprascopy with carbon nanoparticle group and laprascopy surgury group. Numbers of harvested lymph were compared between the 3 groups, and the perioperative complications were evaluated. Results The number of harvested lymph nodes in carbon nanoparticle group （31.5 ± 3.8 ） was significantly higher than those of laprascopy joint carbon nanoparticle group （ 25, 3 ± 2. 6）, F = 5.5, P = 0. 03 and laprascopy group （21.1 ± 2. 7 ）, F = 6. J, P = 0. 01. The number of blackdyed harvested lymph node was 481 （76. 2% ） and the metastasis rate of black-dyed lymph node was 26. 8% in robot joint carbon nanoparticle group. There was no significant difference in the metastasis rate of black-dyed between the robot joint carbon nanoparticle group and laprascopy joint carbon nanoparticle group, Xz = O. 17, P = 0. 22. Conclusions The application of diluted carbon nanoparticle lymphatic tracer helps in the dissection of lymph nodes in Da Vinci robot-assisted radical gastrectomy for advanced gastric cancer.