活性炭示踪指导进展期胃癌手术淋巴结清扫的意义  

Significance of lymph node dissection guided by activated carbon tracer in advanced gastric cancer

作　　者：雷建[1] 黄炯强[1] 胡明[1] 雷大钊[1] 

机构地区：[1]广州医学院第一附属医院胃肠外科,510120

出　　处：《岭南现代临床外科》2008年第3期187-188,共2页Lingnan Modern Clinics in Surgery

基　　金：广东省医学科研基金立项课题;广东省卫生厅(A2007251)

摘　　要：目的探讨活性炭示踪剂指导胃癌淋巴结清扫的应用价值。方法回归性分析70例进展期胃癌的临床资料,对2004年7月至2008年1月期间的22例病人实施活性炭示踪指导淋巴结清扫,作为治疗组;1997年1月至2004年12月应用传统手术方法治疗的胃癌48例,作为对照组;比较两组清扫淋巴结的数目和生存率。结果治疗组全部病例均能满意黑染区域淋巴结;切除淋巴结28～92颗/例,平均68.2±4.1颗/例,对照组切除淋巴结平均17.3±1.1颗/例(P<0.05);淋巴结转移阳性率:治疗组84.2%,对照组45.6%(P<0.05)。半年复发率:治疗组5.6%,对照组23.1%(P<0.05)。结论采用活性炭示踪剂指导胃癌根治术淋巴结清扫可有助于术中辨认淋巴结,增加清扫淋巴结的数目,从而加强区域淋巴结清扫的彻底性,对改善病人的预后有重要意义。Objective To investigate the activated carbon tracer applied value for lymph node dissection of gastric cancer. Methods The clinical data of 70 cases with advanced gastric cancer were analyzed retrospectively. Among them, 22 cases underwent lymph node dissection guided by activated carbon tracer from July 2004 to January 2008 （served as treatment group）. And 48 cases underwent traditional operative method for the treatment of gastric cancer （served as control group） from Janrary 1997 to December 2004. The number of dissected lymph nodes and survival rate were compared between two groups. Results In treatment group , the regional lymph nodes were stained satisfacted in all patients. 28-92 lymph nodes/case were dissected（an average of 68.2±4.1/case）, and in the control group, the average dissected lymph nodes were17.3±1.1/case （P〈0.05）. The positive rate of lymph nodes metastases was 84.2% in treatment group, and 45.6% in control group （P〈0.05）. The recurrence rate of half year was 5.6% in treatment group and 23.1% in control group （P〈0.05）. Conclusion Lymph node dissection guided by activated carbon tracer in gastric cancer would conduce to identify lymph node during operation and enhance dissected efficacy of regional lymph nodes. So, it has important significance to improve the progosis of advanced gastric cancer.

关 键 词：胃癌 淋巴结清扫 活性炭 预后 

分 类 号：R735.2[医药卫生—肿瘤]