术前胃镜纳米炭示踪剂标记在腹腔镜胃癌根治术患者中的应用  

Application of preoperative endoscopic carbon nanoparticles tracer labeling in patients undergoing laparoscopic radical gastric cancer surgery

作　　者：冯云 杨魁 张丹[1] 王淑英[1] 和水祥[1] 樊林[2] 王曙逢[2] 李红霞[1] FENG Yun;YANG Kui;ZHANG Dan;WANG Shuying;HE Shuixiang;FAN Lin;WANG Shufeng;LI Hongxia(Department of Gastroenterology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Department of General Surgery,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院消化内科,陕西西安710061 [2]西安交通大学第一附属医院普通外科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2021年第5期735-739,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：陕西省社会发展科技攻关项目(No.2015SF034);陕西省重点研发计划社会发展领域一般项目(No.2019SF-023)。

摘　　要：目的探讨术前应用胃镜纳米炭标记对行腹腔镜胃癌根治术患者的应用价值。方法纳入2017年1月至2019年12月于西安交通大学第一附属医院行腹腔镜胃癌根治手术的病例,部分病例术前行胃镜纳米炭黏膜下注射,比较分析纳米炭淋巴结示踪剂标记对淋巴结检出数、手术时间、手术并发症等的影响。结果共纳入397例腹腔镜胃癌根治术病例,其中术前行胃镜纳米炭标记78例,无相关并发症出现,其术后病理检出总淋巴结数较对照组明显增加[22.0(4.0)vs.22.0(3.0),P=0.033],且手术时间较对照组明显缩短[(185.0±37.48)min vs.(213.4±23.66)min,P<0.001)]。纳米炭标记中胃镜检查新发现胃癌病灶3例(3.8%),改变原计划手术方式2例(2.6%)。结论术前胃镜纳米炭示踪剂标记有助于缩短腹腔镜胃癌根治术手术时间、增加总淋巴结检出数,以便于更准确地进行TNM分期,且为同时性多发性胃癌的发现提供了契机。Objective To explore the application value of preoperative gastroscopic carbon nanoparticles labeling in patients undergoing laparoscopic radical gastric cancer surgery.Methods We included cases of laparoscopic radical gastric cancer surgery at The First Affiliated Hospital of Xi’an Jiaotong University from January 2017 to December 2019.Some cases received submucosal injection of carbon nanoparticles under the gastroscope before surgery.The effects of carbon nanoparticles labeling on the number of lymph nodes detected,operation duration and surgical complications were compared and analyzed.Results A total of 397 patients undergoing laparoscopic radical gastric cancer surgery were enrolled.Among them,78 cases underwent gastroscopic carbon nanoparticles tracer labeling before operation.No complications were observed.The total number of lymph nodes detected by pathology after surgery in the carbon nanoparticles group significantly increased[(22.0(4.0)vs.22.0(3.0),P=0.033)]while the operation time significantly reduced[(185.0±37.48)min vs.(213.4±23.66)min,P<0.001]compared with those in the control group.New gastric cancer lesions were revealed by gastroscopy in three cases(3.8%)of carbon nanoparticles labeling,and the original planned operation method was changed in two cases(2.6%).Conclusion Preoperative endoscopic carbon nanoparticles tracer labeling can not only help shorten the time of laparoscopic radical surgery for gastric cancer and increase the number of total lymph nodes detected for more accurate TNM staging,but also provide an opportunity for the discovery of synchronous multiple gastric cancer.

关 键 词：纳米炭标记 淋巴结示踪 胃镜 胃癌 腹腔镜 

分 类 号：R735.2[医药卫生—肿瘤]