AIM:To investigate whether activated carbon nanoparticles suspension(ACNS) or methylene blue(MB) can increase the detected number of lymph nodes in colorectal cancer.METHODS:Sixty-seven of 72 colorectal cancer patient...AIM:To investigate whether activated carbon nanoparticles suspension(ACNS) or methylene blue(MB) can increase the detected number of lymph nodes in colorectal cancer.METHODS:Sixty-seven of 72 colorectal cancer patients treated at our hospital fulfilled the inclusion criteria of the study which was conducted from December 2010 to February 2012.Seven patients refused to participate.Eventually,60 patients were included,and randomly assigned to three groups(20 in each group):ACNS group(group A),MB group(group B) and non-stained conventional surgical group(group C).In group A,patients received subserosal injection of 1 mL ACNS in a 4-quadrant region around the mass.In group B,the main artery of specimen was identified and isolated after the specimen was removed,and 2 mL MB was slowly injected into the isolated,stretched and fixed vessel.In group C,no ACNS and MB were injected.All the mesentery lymph nodes were isolated and removed systematically by visually inspecting and palpating the adipose tissue.RESULTS:No difference was observed among the three groups in age,gender,tumor location,tumor diameter,T-stage,degree of differentiation,postoperative complications and peritoneal drainage retention time.The total number of detected lymph nodes was 535,476 and 223 in the three groups,respectively.The mean number of detected lymph nodes per patient was significantly higher in group A than in group C(26.8 ± 8.4 vs 12.2 ± 3.2,P < 0.001).Similarly,there were significantly more lymph nodes detected in group B than in group C(23.8 ± 6.9 vs 12.2 ± 3.2,P < 0.001).However,there was no significant difference between group A and group B.There were 50,46 and 32 metastatic lymph nodes dissected in 13 patients of group A,10 patients of group B and 11 patients of group C,without significant differences among the three groups.Eleven of the 60 patients had insufficient number of detected lymph nodes(< 12).Only one patient with T 4a rectal cancer had 10 lymph nodes detected in group B,the other 10 patients were all from group C.Based on the different diameter categories,the number of detected lymph nodes in groups A and B was significantly higher than in group C.However,there was no statistically significant difference between group A and group B.The metastatic lymph nodes were not significant different among the three groups.Similarly,tumor location,T stage and tumor differentiation did not affect the staining results.Body mass index was a minor influencing factor in the two different staining methods.The stained lymph nodes can easily be identified from the mesenteric adipose tissues,and the staining time for lymph nodes was not significantly different compared with unstained group.None of the patients in groups A and B had drug-related complications.CONCLUSION:Both activated carbon nanoparticles suspension in vivo and methylene blue in vitro can be used as tracers to increase the detected number of lymph nodes in colorectal cancer.展开更多
<strong>Background:</strong> We aimed to investigate the ability of carbon nanoparticles to identify parathyroid glands with vasculature during thyroid surgery. <strong>Material and methods:</stro...<strong>Background:</strong> We aimed to investigate the ability of carbon nanoparticles to identify parathyroid glands with vasculature during thyroid surgery. <strong>Material and methods:</strong> Totally 42 patients with various thyroid diseases were selected for the prospective research of carbon nanoparticle injection used in thyroidectomy. Another 42 patients without receiving carbon nanoparticle injection were selected as the control group. All cases underwent total or subtotal bilateral thyroidectomy. Before the ligation of the superior and inferior poles of the thyriod lobes, 0.1 mL of a carbon nanoparticle suspension was injected into the two poles. Important tissues such as the recurrent laryngeal nerve, parathyroid gland with blood supply and the inferior thyroid artery were identified and protected. <strong>Results:</strong> The parathyroid glands with vasculature were not stained and thus remained the primary color in all cases, while abnormal thyroid tissues were stained black. After 5 minutes, thyroid lobes were injected with the carbon nanoparticle suspension and the original color of parathyroid glands was unchanged. Even the parathyroids with blood supply can be identified and protected. The number of parathyroid glands for autotransplantation was one in the test group and six in the control group. At one day after the thyroid surgery, hypocalcemia became detectable in four patients of the test group and in five of the control group. Twenty-four instances of hypoparathyroidism occurred at 1 day after surgery in the control group, while ten instances in the test group. <strong>Conclusion:</strong> Intraoperatvie carbon nanoparticle suspension injection is an effective and safe technique for guiding thyroid surgery. The carbon nanoparticle suspension plays an important role in identifying the vasculatural parathyroid glands, while protecting the physiologic function of the parathyroid glands during surgery.展开更多
Background:Localization of the primary tumor and ensuring safe distal surgical margins(DSMs)following neoadjuvant chemoradiotherapy(nCRT)are challenging in locally advanced rectal cancers(LARCs).This study investigate...Background:Localization of the primary tumor and ensuring safe distal surgical margins(DSMs)following neoadjuvant chemoradiotherapy(nCRT)are challenging in locally advanced rectal cancers(LARCs).This study investigated the effectiveness of carbon nanoparticles suspension(CNS)for labeling the primary tumor and allowing precise tumor resection after nCRT.Methods:Clinicopathological data of LARC patients who underwent nCRT followed by laparoscopic radical anal preservation surgery at our center between January 2018 and February 2023 were prospectively collected.The patients were divided into the CNS tattooed(CNS)and non-tattooed(control)groups.In the CNS group,CNS was injected in four quadrants on the anal side 1 cm away from the lower tumor margin.DSMs were determined through intraoperative distal rectal examination in the control group and observation of CNS tattoos in the CNS group.DSM lengths and positive DSM rates were compared between the two groups to analyse the feasibility and effectiveness of CNS for labeling LARCs before nCRT.Results:There was no statistically significant difference in the basic demographic data,effectiveness of nCRT,or post-operative recovery rates between the two groups(all P>0.05).In the CNS group,CNS tattoos were observed on the outside of the rectal wall,with an overall efficiency of 87.1%(27/31).The CNS group had fewer positive DSMs and safer DSM lengths(2.73±0.88 vs 2.12±1.15 cm,P=0.012)than the control group(P<0.05).Conclusions:Endoscopic ultrasound-guided injection of CNS tattoos before nCRT could effectively label the LARCs,ensuring safe DSMs during anus-preserving surgeries(Chictr.org.cn No.:ChiCTR2300068991).展开更多
文摘AIM:To investigate whether activated carbon nanoparticles suspension(ACNS) or methylene blue(MB) can increase the detected number of lymph nodes in colorectal cancer.METHODS:Sixty-seven of 72 colorectal cancer patients treated at our hospital fulfilled the inclusion criteria of the study which was conducted from December 2010 to February 2012.Seven patients refused to participate.Eventually,60 patients were included,and randomly assigned to three groups(20 in each group):ACNS group(group A),MB group(group B) and non-stained conventional surgical group(group C).In group A,patients received subserosal injection of 1 mL ACNS in a 4-quadrant region around the mass.In group B,the main artery of specimen was identified and isolated after the specimen was removed,and 2 mL MB was slowly injected into the isolated,stretched and fixed vessel.In group C,no ACNS and MB were injected.All the mesentery lymph nodes were isolated and removed systematically by visually inspecting and palpating the adipose tissue.RESULTS:No difference was observed among the three groups in age,gender,tumor location,tumor diameter,T-stage,degree of differentiation,postoperative complications and peritoneal drainage retention time.The total number of detected lymph nodes was 535,476 and 223 in the three groups,respectively.The mean number of detected lymph nodes per patient was significantly higher in group A than in group C(26.8 ± 8.4 vs 12.2 ± 3.2,P < 0.001).Similarly,there were significantly more lymph nodes detected in group B than in group C(23.8 ± 6.9 vs 12.2 ± 3.2,P < 0.001).However,there was no significant difference between group A and group B.There were 50,46 and 32 metastatic lymph nodes dissected in 13 patients of group A,10 patients of group B and 11 patients of group C,without significant differences among the three groups.Eleven of the 60 patients had insufficient number of detected lymph nodes(< 12).Only one patient with T 4a rectal cancer had 10 lymph nodes detected in group B,the other 10 patients were all from group C.Based on the different diameter categories,the number of detected lymph nodes in groups A and B was significantly higher than in group C.However,there was no statistically significant difference between group A and group B.The metastatic lymph nodes were not significant different among the three groups.Similarly,tumor location,T stage and tumor differentiation did not affect the staining results.Body mass index was a minor influencing factor in the two different staining methods.The stained lymph nodes can easily be identified from the mesenteric adipose tissues,and the staining time for lymph nodes was not significantly different compared with unstained group.None of the patients in groups A and B had drug-related complications.CONCLUSION:Both activated carbon nanoparticles suspension in vivo and methylene blue in vitro can be used as tracers to increase the detected number of lymph nodes in colorectal cancer.
文摘<strong>Background:</strong> We aimed to investigate the ability of carbon nanoparticles to identify parathyroid glands with vasculature during thyroid surgery. <strong>Material and methods:</strong> Totally 42 patients with various thyroid diseases were selected for the prospective research of carbon nanoparticle injection used in thyroidectomy. Another 42 patients without receiving carbon nanoparticle injection were selected as the control group. All cases underwent total or subtotal bilateral thyroidectomy. Before the ligation of the superior and inferior poles of the thyriod lobes, 0.1 mL of a carbon nanoparticle suspension was injected into the two poles. Important tissues such as the recurrent laryngeal nerve, parathyroid gland with blood supply and the inferior thyroid artery were identified and protected. <strong>Results:</strong> The parathyroid glands with vasculature were not stained and thus remained the primary color in all cases, while abnormal thyroid tissues were stained black. After 5 minutes, thyroid lobes were injected with the carbon nanoparticle suspension and the original color of parathyroid glands was unchanged. Even the parathyroids with blood supply can be identified and protected. The number of parathyroid glands for autotransplantation was one in the test group and six in the control group. At one day after the thyroid surgery, hypocalcemia became detectable in four patients of the test group and in five of the control group. Twenty-four instances of hypoparathyroidism occurred at 1 day after surgery in the control group, while ten instances in the test group. <strong>Conclusion:</strong> Intraoperatvie carbon nanoparticle suspension injection is an effective and safe technique for guiding thyroid surgery. The carbon nanoparticle suspension plays an important role in identifying the vasculatural parathyroid glands, while protecting the physiologic function of the parathyroid glands during surgery.
基金supported by Fujian Province Science and Technology Plan Project Natural Science Foundation in 2020[no.2020J011141]Fujian Province Guiding Project in 2021[no.2021Y0061]Army Logistics Research Program[no.CLB21J016].
文摘Background:Localization of the primary tumor and ensuring safe distal surgical margins(DSMs)following neoadjuvant chemoradiotherapy(nCRT)are challenging in locally advanced rectal cancers(LARCs).This study investigated the effectiveness of carbon nanoparticles suspension(CNS)for labeling the primary tumor and allowing precise tumor resection after nCRT.Methods:Clinicopathological data of LARC patients who underwent nCRT followed by laparoscopic radical anal preservation surgery at our center between January 2018 and February 2023 were prospectively collected.The patients were divided into the CNS tattooed(CNS)and non-tattooed(control)groups.In the CNS group,CNS was injected in four quadrants on the anal side 1 cm away from the lower tumor margin.DSMs were determined through intraoperative distal rectal examination in the control group and observation of CNS tattoos in the CNS group.DSM lengths and positive DSM rates were compared between the two groups to analyse the feasibility and effectiveness of CNS for labeling LARCs before nCRT.Results:There was no statistically significant difference in the basic demographic data,effectiveness of nCRT,or post-operative recovery rates between the two groups(all P>0.05).In the CNS group,CNS tattoos were observed on the outside of the rectal wall,with an overall efficiency of 87.1%(27/31).The CNS group had fewer positive DSMs and safer DSM lengths(2.73±0.88 vs 2.12±1.15 cm,P=0.012)than the control group(P<0.05).Conclusions:Endoscopic ultrasound-guided injection of CNS tattoos before nCRT could effectively label the LARCs,ensuring safe DSMs during anus-preserving surgeries(Chictr.org.cn No.:ChiCTR2300068991).