纳米碳示踪剂在腹腔镜结直肠癌手术中的应用价值  

Application value of nano-carbon tracer in laparoscopic colorectal cancer surgery

作　　者：刘津杉[1] 吴立然 敬国敏 黄锡明[1] 樊昆[1] LIU Jinshan;WU Liran;JING Guomin(Department of General Surgery,The People’s Hospital of Qijiang District,Chongqing 401420,China)

机构地区：[1]重庆市綦江区人民医院普通外科

出　　处：《河北医药》2019年第19期2955-2957,2961,共4页Hebei Medical Journal

摘　　要：目的探讨纳米碳示踪剂在腹腔镜结直肠癌手术中的应用价值。方法选取结直肠癌病例65例,分为观察组32例和对照组33例,观察组术前1 d在肠镜下行肿瘤周围纳米碳注射,对照组不采取干预措施,2组均接受腹腔镜辅助结直肠癌根治术,行淋巴结清扫时,对观察组标准清扫范围外的黑染淋巴结单独处理,对照组淋巴结按常规处理。分析术后淋巴结检出情况,分别记录淋巴结总数、阳性淋巴结数、微小淋巴结数、微小淋巴结阳性数、标准范围外黑染淋巴结数及阳性率。结果2组分别检出淋巴结616个和518个,差异有统计学意义[(19.3±2.6)个vs(15.6±2.5)个,P<0.05];其中观察组淋巴结阳性18例共94个,对照组17例共84个,阳性淋巴结比较观察组稍高,但差异无统计学意义[(5.2±1.8)个vs(4.9±1.6)个,P=0.63];观察组微小淋巴结共146个,对照组126个,差异有统计学意义[(4.7±1.1)个vs(3.8±1.2)个,P<0.05],阳性微小淋巴结比较差异无统计学意义[(1.8±0.5)个vs(1.7±0.7)个,P=0.54];观察组标准范围外清扫黑染淋巴结共43枚,阳性3枚,阳性率6.98%。结论术前应用纳米碳示踪剂可增加腹腔镜结直肠癌根治术淋巴结检出个数,有利于术后准确分期及治疗,值得临床推广。Objective To investigate the application value of nano-carbon tracer in laparoscopic colorectal cancer surgery.Methods A total of 65 patients with colorectal cancer were enrolled in thestudy,who were divided into observation group(n=32)and control group(n=33).The patients in observation group were injected with nano-carbon around the tumor tissues at 1d before operation,and the patients in control group did not give intervention measure.The patients in both groups were treated by laparoscope-assistanced radical resection of rectal carcinoma.The black-stained lymph nodes outside the standard cleaning range in observation group were treated separately,however,which in control group were treated by conventional method.The total number of lymph nodes,the number of positive lymph nodes,the number of micro-lymph nodes,the number of black-stained lymph nodes outside the standard range,and the positive rate were observed and compared between the two groups.Results A total of 616 lymph nodes were detected in observation group,and 518 lymph nodes were detected in control group,there were significant differences between the two groups(P<0.05),in which,there were 94 positive lymph nodes(18 cases)in observation group,and 84 positive lymph nodes(17 cases)in control group,but there were no significant differences between the two groups(P>0.05).There were 146 micro-lymph nodes in observation group and 126 micro-lymph nodes in control group,there were significant differences between the two groups(P<0.05).However there were no significant differences in positive micro-lymph nodes between the two groups(P>0.05).A total of 43 black-stained lymph nodes were cleaned outside the standard range in observation group,with 3 positive ones,and the positive rate was 6.98%.Conclusion The application of nano-carbon tracer before laparoscope-assistanced radical resection of rectal carcinoma can increase the detected number of postoperative lymph nodes,which is conducive to accurate postoperative staging and the following treatment,therefore,wh

关 键 词：纳米碳示踪剂 结直肠癌 淋巴结转移 分期 

分 类 号：R735.37[医药卫生—肿瘤]