磁示踪技术在食道肿瘤标记定位中的应用

Application of magnetic tracer technique in labeling and localization of esophageal tumors

目的设计并加工用于胸腔镜食道肿瘤术中标记定位的磁体,通过实验犬对磁示踪技术(MTT)的可行性和安全性进行验证。方法用于食道肿瘤标记定位的磁示踪磁体包括示踪磁体(TM)及寻踪磁体(PM)两部分,采用钕铁硼(NdFeB)材料加工而成。选择6只雄性健康Beagle犬,全身麻醉后通过内镜下软组织夹将TM钳夹并固定于食管假定的肿瘤旁边,24 h后行胸腔镜,经操作孔置入PM于食道的可疑病变附近,PM与TM因磁力相互吸引,从而实现食管胸腔镜下手术时对肿瘤的定位。结果成功加工出可用于胸腔镜食道肿瘤术中标记定位的磁TM。6只Beagle犬在内镜下均成功留置TM于食管假定的肿瘤边缘,操作中无磁体滑脱、出血等副损伤。24 h后,胸腔镜手术下顺利置入PM,且PM与TM成功完成自动相吸,实现了胸腔镜下对食道肿瘤的定位和识别,整个过程操作顺利,未出现任何副损伤。结论基于MTT的胃镜联合胸腔镜食道肿瘤标记定位安全可行,具有临床应用价值。

Objective To design and process magnetic markers for thoracoscopic esophageal tumors,and verify the feasibility and safety of magnetic tracer technique by experimental dogs.Methods The magnetic tracer magnets for esophageal tumor labeling and localization include tracer magnets and pursuit magnets,which are made of NdFeB material.Six healthy male Beagle dogs were made of tracer magnet clamp and fixed to esophageal hypothetical tumor by endoscopic soft tissue clip after general anesthesia.Thoracoscopy was performed 24 hours later,and the pursuit magnet was placed near the esophagus of suspected lesion through operation hole,and the tracer magnet and pursuit magnet attracted each other because of magnetic force,so as to realize the localization of the tumor during esophageal thoracoscopic surgery.Results The magnetic tracer magnets which can be used for the marking and localization of thoracoscopic esophageal tumors were successfully processed.6 Beagle dogs successfully retained the tracer magnets at the assumed tumor edge of the esophagus under endoscopy,and there were no secondary injuries such as magnet or slippage and bleeding in the operation.24 hours later,the pursuit magnet was successfully inserted under thoracoscopic surgery,and the tracer magnet and pursuit magnet were successfully sucked into each other,thus realizing the localization and recognition of esophageal tumors under thoracoscopic surgery.The whole process operated smoothly and no side damage occurred.Conclusion Gastroscopy combined with thoracoscopy based on magnetic tracer technique is safe and feasible,and can be applied in clinical practice.