腹腔镜在早期胃癌前哨淋巴结检测中的应用  

Laparoscopic Application in Early Gastric Cancer Sentinel Lymph Node Detection

作　　者：陶锋[1] 吕杰青[1] 叶民峰[1] 许国权[1] 徐关根[1] 王海峰[1] 孙爱静[2] 

机构地区：[1]浙江省绍兴市人民医院胃肠外科,绍兴312000 [2]浙江省绍兴市人民医院病理科,绍兴312000

出　　处：《中国中西医结合外科杂志》2013年第4期371-373,共3页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:探讨应用腹腔镜技术检测早期胃癌前哨淋巴结(SLN)方法以及对手术方式选择的意义。方法:31例确诊胃癌患者,根据腹腔镜探查、胃镜描述和术中胃镜定位,用腹腔镜穿刺针在病灶周围黏膜下层分3～4点注入亚甲蓝,10min内根据腹腔镜检查确定蓝染淋巴结(即SLN)切取周围组织,再在体外摘出蓝染淋巴结送病理检查,行腹腔镜下胃癌D2根治术。结果:31例全部检出SLN,SLN预测胃周淋巴结转移准确率、敏感性和特异性均一致。结论:腹腔镜下亚甲蓝多点注射是一个操作方便、结果可靠的检测早期胃癌前哨淋巴结的方法,对早期胃癌腹腔镜下淋巴结清扫范围的确定提供了一定的指导意义。Objective To identify the value of sentinel lymph node（SLN） detection in laparoscopic gastrectomy.Methods In patients without metastasis during laparoscopic exploration,2～4 mL of methylene blue dye was multi-pointly injected in the peritumoral submucosa,according to esophagogastroduodenoscopy examination and laparotomy.All the blue-stained nodes appeared within 10 minutes were taken as SLNs.All of them were resected by harmonic scalpel,and then were sent for pathological examination.Results SLN identified in all of the total 31 patients （100%）.The sensitivity,accuracy,specificity and false-negative rate of SLN mapping to predict lymph node metastasis all were 100%.Conclusion Sentinel lymph node mapping with methylene blue dye staining during laparoscopic operation is feasible and reliable,which is valuable to guide the range of lymph node excision.

关 键 词：前哨淋巴结 胃癌 亚甲蓝 腹腔镜 

分 类 号：R616.2[医药卫生—外科学]