淋巴示踪剂导引腹腔镜辅助下远端胃癌根治术的临床研究  

Clinical study of laparoscopy-assisted distal gastrectomy for gastric cancer guided by lymph tracer

作　　者：李松岩[1] 杜晓辉[1] 陈凛[1] 沈笛[1] 孙刚[2] 王新友[1] 李荣[1] 

机构地区：[1]解放军总医院普通外科,北京100853 [2]解放军总医院消化内科,北京100853

出　　处：《中国普通外科杂志》2010年第4期383-385,共3页China Journal of General Surgery

基　　金：国家自然科学基金资助项目(60601018);军队"十一五"科技攻关课题(06G107);北京市科技新星计划课题(2006A51)

摘　　要：目的探讨纳米炭示踪剂引导腹腔镜辅助下远端胃癌D2根治术的临床效果。方法回顾性分析近2年间行远端胃癌根治术患者109例的临床资料。(1)观察组,21例。用纳米炭作为淋巴示踪剂引导行腹腔镜辅助下远端胃癌D2根治术;(2)对照组,40例。常规腹腔镜辅助下远端胃癌D2根治术组;(3)开腹D2根治手术组,48例。结果3组患者性别构成及年龄无统计学差异。观察组清扫淋巴结数目显著多于对照组(均P<0.05);观察组手术出血量平均(156±102)mL,少于常规腹腔镜组的(182±109)mL和开腹手术组的(230±112)mL;观察组平均住院日为(11.9±5.8)d,少于开腹手术组的(17.5±9.4)d。结论纳米炭淋巴示踪剂在腹腔镜胃癌根治术中具有良好的靶向性,能增加淋巴结清除数目,减小手术创伤,术后患者恢复快。Objective To evaluate the effect of laparoscopy-assisted radical resection of gastric cancer guided by carbon nanopartical tracer. Methods The clinical records of 109 patients who received radical resection of gastric cancer in PLA General hospital in the past 2 years were divided into three groups and analzed retrospectively. The observation group included 21 patients who underwent laparoscopic D2 radical resection of gastric cancer guided by carbon nanopartical lymph tracer; the control groups included 40 patients who underwent routine laparotscopic D2 surgery; and 48 patients who underwent open D2 radical operation as open surgery group. Results There was no significant difference in gender and age between the three groups. The number of lymph nodes dissected in the observation group was larger than that in control groups （ both P 〈 0.05）. The mean volume of blood loss in the observation group was （156 ±102）mL,less than the control group [ （ 182 ± 109） mL] and open surgery group[ （230 ± 112） mL]. The average hospital stay of the observation group was （11. 9 ±5. 8） d, shorter than the open surgery group [ （17. 5±9. 4） d]. Conclusions Carbon nanopartical lymph tracer has excellent target ability for lymphadenectomy in laparoscopic distal gastrectomy for gastric cancer. It can increase the number of dissected lymph nodes, reduce surgical trauma and achieve faster postoperative recovery.

关 键 词：胃肿瘤/外科学 腹腔镜 淋巴示踪剂 淋巴结清扫术 

分 类 号：R735.2[医药卫生—肿瘤]