磁示踪技术在食道肿瘤标记定位中的应用  

Application of magnetic tracer technique in labeling and localization of esophageal tumors

作　　者：马佳[1] 李江 樊茜 吝怡 吉琳 常凯曦 李建辉[1] 吕毅[4] 严小鹏[4] Jia Ma;Jiang Li;Qian Fan;Yi Lin;Lin Ji;Kai-xi Chang;Jian-hui Li;Yi Lü;Xiao-peng Yan(Department of Surgical Oncology,Shaanxi Provincial People’s Hospital,Xi’an,Shaanxi 710068,China;Department of Graduate School,Xi’an Medical University,Xi’an,Shaanxi 710021,China;Department of Qide College,Xi’an Jiaotong University,Xi’an,Shaanxi 710061,China;National Local Joint Engineering Research Center for Precision Surgery&Regenerative Medicine,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an,Shaanxi 710061,China)

机构地区：[1]陕西省人民医院肿瘤外科,陕西西安710068 [2]西安医学院研究生院,陕西西安710021 [3]西安交通大学启德书院,陕西西安710061 [4]西安交通大学第一附属医院精准外科与再生医学国家地方联合工程研究中心,陕西西安710061

出　　处：《中国内镜杂志》2020年第3期69-72,共4页China Journal of Endoscopy

基　　金：国家自然科学基金(No:81700545);陕西省自然科学基础研究计划(No:2017JQ8021);中央高校基本科研业务费专项资金(No:xjj2018jchz14);陕西省肿瘤微创精准治疗技术研究创新团队(No:2014KCT-24)。

摘　　要：目的设计并加工用于胸腔镜食道肿瘤术中标记定位的磁体,通过实验犬对磁示踪技术(MTT)的可行性和安全性进行验证。方法用于食道肿瘤标记定位的磁示踪磁体包括示踪磁体(TM)及寻踪磁体(PM)两部分,采用钕铁硼(NdFeB)材料加工而成。选择6只雄性健康Beagle犬,全身麻醉后通过内镜下软组织夹将TM钳夹并固定于食管假定的肿瘤旁边,24 h后行胸腔镜,经操作孔置入PM于食道的可疑病变附近,PM与TM因磁力相互吸引,从而实现食管胸腔镜下手术时对肿瘤的定位。结果成功加工出可用于胸腔镜食道肿瘤术中标记定位的磁TM。6只Beagle犬在内镜下均成功留置TM于食管假定的肿瘤边缘,操作中无磁体滑脱、出血等副损伤。24 h后,胸腔镜手术下顺利置入PM,且PM与TM成功完成自动相吸,实现了胸腔镜下对食道肿瘤的定位和识别,整个过程操作顺利,未出现任何副损伤。结论基于MTT的胃镜联合胸腔镜食道肿瘤标记定位安全可行,具有临床应用价值。Objective To design and process magnetic markers for thoracoscopic esophageal tumors,and verify the feasibility and safety of magnetic tracer technique by experimental dogs.Methods The magnetic tracer magnets for esophageal tumor labeling and localization include tracer magnets and pursuit magnets,which are made of NdFeB material.Six healthy male Beagle dogs were made of tracer magnet clamp and fixed to esophageal hypothetical tumor by endoscopic soft tissue clip after general anesthesia.Thoracoscopy was performed 24 hours later,and the pursuit magnet was placed near the esophagus of suspected lesion through operation hole,and the tracer magnet and pursuit magnet attracted each other because of magnetic force,so as to realize the localization of the tumor during esophageal thoracoscopic surgery.Results The magnetic tracer magnets which can be used for the marking and localization of thoracoscopic esophageal tumors were successfully processed.6 Beagle dogs successfully retained the tracer magnets at the assumed tumor edge of the esophagus under endoscopy,and there were no secondary injuries such as magnet or slippage and bleeding in the operation.24 hours later,the pursuit magnet was successfully inserted under thoracoscopic surgery,and the tracer magnet and pursuit magnet were successfully sucked into each other,thus realizing the localization and recognition of esophageal tumors under thoracoscopic surgery.The whole process operated smoothly and no side damage occurred.Conclusion Gastroscopy combined with thoracoscopy based on magnetic tracer technique is safe and feasible,and can be applied in clinical practice.

关 键 词：食道肿瘤 磁示踪技术 胃镜 胸腔镜手术 磁外科 

分 类 号：R735.1[医药卫生—肿瘤]