摘要
目的探讨单点-点压法注射纳米碳在腹腔镜结肠癌根治术中的应用。方法前瞻性选取2021年1月至2022年12月首都医科大学宣武医院收治69例结肠癌患者,采用随机数字法分为示踪组和对照组。示踪组术前通过电子肠镜于病灶非系膜侧使用单点-点压法黏膜下注射纳米碳悬浊液原液标记示踪,两组均行腹腔镜结肠癌根治术,确定切除范围,切除病灶肠断及周围组织,切除后组织送病理科检查。观察记录两组手术用时、手术探查用时、术中出血量、术后排气时间、淋巴结数量、微小淋巴结(<5 mm)数量、转移阳性淋巴结数量、纳米碳注射用时、注射穿透喷溅事件例数。结果示踪组手术用时、术中探查用时均短于对照组,差异有统计学意义(P<0.05)。示踪组出现1例(2.9%)穿透喷溅事件。两组术中出血量、术后排气时间、淋巴结检出总数、微小淋巴结检出数和转移阳性淋巴结数相比,差异均无统计学意义(P>0.05)。结论根据病灶、结肠结构及位置特点使用单点-点压法注射纳米碳在腹腔镜结肠癌根治术中应用在病灶定位、淋巴示踪效果理想,可以安全、准确、有效地定位病变.判定远切缘,缩短手术时间,降低操作难度,简化操作。
Objective To investigate the application of"single point-pressure"injection of carbon nanoparticles in laparoscopic radical resection of colon cancer.Methods A total of 69 patients with colon cancer admitted to Xuanwu Hospital of Capital Medical University from January 2021 to December 2022 were prospectively selected and divided into tracer group and control group by random number method.In the tracer group,the non-mesangial side of the lesion was marked by single point-point pressure injection of nano-carbon suspension in the submucosa before operation by electronic colonoscopy.Laparoscopic radical resection of colon cancer was performed in both groups.The scope of resection was determined,the lesion and surrounding tissues were removed,and the resected tissues were sent to the pathology department for examination.The operation time,operation exploration time,intraoperative blood loss,postoperative exhaust time,the number of lymph nodes,the number of small lymph nodes(<5 mm),the number of positive metastatic lymph nodes,the time of carbon nanoparticles injection,and the number of injection penetration and splash events were observed and recorded.Results The total operation time and intraoperative exploration time in the tracer group were shorter than those in the control group,with a statistically significant difference(P<0.05).In the tracer group,there was 1 case of penetrating spatter(2.9%).There were no significant differences in the amount of blood loss,postoperative exhaust time,the total number of lymph nodes detected,the number of small lymph nodes detected and the number of lymph nodes with positive metastasis between the two groups(P>0.05).Conclusion According to the characteristics of the lesion,colon structure and location,the application of"single point-point pressure"injection of carbon nanoparticles in laparoscopic radical resection of colon cancer is ideal in lesion localization and lymphatic tracing,which can safely,accurately and effectively locate the lesion,determine the distal resection margin,shorten the operation time,reduce the difficulty of operation,and simplify the operation.
作者
李英茹
李非
张玉茹
刘莉婷
Yingru Li;Fei Li;Yuru Zhang;Liting Liu(Department of General Surgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Surgery,Beijing Anorectal Hospital,Beijing 100230,China)
出处
《中华消化病与影像杂志（电子版）》
2023年第6期414-417,共4页
Chinese Journal of Digestion and Medical Imageology(Electronic Edition)
关键词
结肠癌
纳米碳
淋巴结
病灶定位
Colon cancer
Nano carbon
Lymph nodes
Localization of lesion
