纳米碳在腹腔镜胃癌根治术淋巴结示踪中的应用

Application of nanocarbon in lymph node tracing in laparoscopic radical gastrectomy for gastric cancer

目的探讨纳米碳在腹腔镜胃癌根治术淋巴结示踪的可行性。方法选取2016年3-10月该院胃肠外科收治的49例胃癌患者为研究对象,分为纳米碳组(23例)和对照组(26例)。纳米碳组采用腹腔镜下静脉输液针注射法在肿瘤周围浆膜下注射纳米碳后行腹腔镜胃癌根治术,对照组则常规行腹腔镜胃癌根治术。比较2组淋巴结检出及手术情况,并观察围术期并发症发生情况。结果与对照组比较,纳米碳组淋巴结检出个数更多,微小淋巴结检出率更高,淋巴结检出时间更短,手术时间更长,手术出血量更低,差异有统计学意义(P<0.05)。纳米碳组淋巴结黑染率为54.43%(412/757),其中淋巴结转移率为8.50%(35/412),高于纳米碳组未黑染淋巴结转移率[6.37%(22/345)],但差异无统计学意义(P>0.05)。2组并发症发生率比较差异无统计学意义(P>0.05),无手术相关死亡,围术期未发生与纳米碳注射相关的不良反应。结论纳米碳可用于腹腔镜胃癌根治术淋巴结示踪。

Objective To investigate the feasibility of nanocarbon in lymph node tracing in laparoscopic radical gastrectomy for gastric cancer.Methods A total of 49 patients with gastric cancer who were admitted to Department of Gastrointestinal Surgery of this hospital from March to October 2016 were selected as the research objects,and they were divided into the nanocarbon group(23 cases)and the control group(26 cases).The nanocarbon group was given laparoscopic radical gastrectomy for gastric cancer after subserosal injection of nanocarbons around the tumor by laparoscopic intravenous infusion needle injection,while the control group was given routine laparoscopic radical gastrectomy.The lymph node detection and operation were compared between the two groups,and the perioperative complications were observed.Results Compared with the control group,the number of lymph nodes detected in the nanocarbon group was higher,the detection rate of tiny lymph nodes was higher,the detection time of lymph nodes was shorter,the operation time was longer,and the surgical blood loss was lower,the differences were statistically significant(P<0.05).The black-stained rate of lymph nodes in the nanocarbon group was 54.43%(412/757),of which the lymph node metastasis rate was 8.50%(35/412),which was higher than that of the non-black-stained lymph nodes in the nanocarbon group[6.37%(22/345)],but the difference was not statistically significant(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05),there was no operation-related death,and no adverse reactions related to nanocarbon injection occurred during the perioperative period.Conclusion Nanocarbon can be used for lymph node tracing in laparoscopic radical gastrectomy for gastric cancer.