摘要
目的评价使用纳米碳在腹腔镜直肠癌根治术中的淋巴清扫效果。方法选取2016年8月至2017年8月在北京市大兴区人民医院普外科接受腹腔镜直肠癌根治手术的80例直肠癌患者,随机分为纳米碳组与对照组,每组40例。纳米碳组分两个时间点(术前16～18小时及术中)肠镜下于肿瘤下缘及侧壁黏膜下注射纳米碳,每个时间点各20例患者。根据肿瘤不同位置确定手术范围。标本切出后30 min内送至病理科,并由专人协助病理科医师分检淋巴结。结果纳米碳组检出的淋巴结数明显多于对照组(t=3.32,P <0.05),黑染淋巴结阳性(转移)率明显高于非黑染淋巴结阳性(转移)率(χ~2=42.76,P <0.001),差异均有统计学意义。术前16～18 h组与术中注射组清除淋巴结数目、淋巴结阳性率差异无统计学意义(χ~2=0.032,P> 0.05)。结论使用纳米碳可增加腹腔镜直肠癌根治术中淋巴结检出数,经纳米碳示踪出现黑染的淋巴结阳性率更高。术前16～18 h注射纳米碳效果肯定,便于临床工作安排,值得推广应用。
Objective To evaluate lymph node dissection effect after using carbon nanoparticles in laparoscopic radical resection for rectal cancer. Methods Eighty patients accepted laparoscopic radical resection for rectal cancer in People＇s Hospital of Beijing Daxing District from August 2016 to August 2017 were selected. They were randomly assigned as carbon nanoparticles group and control group, with forty patients in each group. Patients in carbon nanoparticles group received rejection of carbon nanoparticles into submucosal layer at the inferior border and lateral wall of tumor under enteroscopy guidance at two different times （16-18 hours before operation and during operation）, and there were twenty patients at each time. Resection range was determined according to the location of tumor. Surgical specimens were delivered to department of pathology within thirty minutes after tumors were resected, and special person was assigned to assist lymph node sorting. Results The amount of detecting lymph node in carbon nanoparticles group was more than control group （t=3.32, P 〈 0.05）, and positive （metastasis） rate in black dyed lymph node was higher than non-black dyed （χ^2=42.76, P 〈 0.001）, the difference was statistically significant. There was no significant difference in the amount of detecting lymph node and lymph node positive （metastasis） rate between patients rejecting carbon nanoparticles sixteen-eighteen hours before operation and during operation （χ^2=0.032, P 〉 0.05）. Conclusions The application of carbon nanoparticles can increase the amount of detecting lymph nodes during laparoscopic radical resection for rectal cancer, and black dyed lymph nodes which axe traced by carbon nanoparticles have higher positive rate. The effect of rejecting carbon nanoparticles sixteen-eighteen hours before operation is confirmed, also it is helpful to arrange clinical work, so this technique deserves generalization and application.
作者
赵磊
刘春庆
刘建
黄涛
张伟
赵金
Zhao Lei;Liu Chunqing;Liu Jian;Huang Tao;Zhang Wei;Zhao Jin(Department of General Surgery,People＇s Hospital of Beijing Daxing District,Beijing 102600,China)
出处
《中华结直肠疾病电子杂志》
2018年第5期442-446,共5页
Chinese Journal of Colorectal Diseases(Electronic Edition)
关键词
腹腔镜
直肠肿瘤
纳米碳
淋巴示踪
淋巴结阳性率
Laparoscopes
Rectal neoplasms
Carbon nanoparticles
lymphatic trace
Lymph node positive rate
