直肠黏膜下层注射纳米炭混悬注射液对中低位直肠癌新辅助治疗后淋巴结检出情况及吻合口安全性的影响分析  

Effect of submucosal injection of carbon nanoparticles on lymph node yield and anastomosis safety after neoadjuvant therapy for mid-and low rectal cancer

作　　者：金鑫[1] 谭皓 吴潇烁 李玉英[1] 孙锋[1] Jin Xin;Tan Hao;Wu Xiaoshuo;Li Yuying;Sun Feng(Department of Colorectal Surgery,The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院肛肠科,广东广州510405

出　　处：《结直肠肛门外科》2021年第4期334-337,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨直肠黏膜下层注射纳米炭混悬注射液对中低位直肠癌新辅助治疗后淋巴结检出情况及吻合口安全性的影响。方法回顾性分析广州中医药大学第一附属医院肛肠科2017年1月至2021年1月收治的72例中低位直肠癌患者的临床资料,患者均在新辅助治疗后行保肛根治术治疗。将其中于术前24 h经肛门镜引导在齿状线上方2 cm处直肠黏膜下层注射纳米炭混悬注射液的31例患者归为观察组,将未注射纳米炭混悬注射液的41例患者归为对照组。比较两组淋巴结检出相关情况、吻合口相关并发症发生情况。结果观察组平均淋巴结检出数目较对照组多,淋巴结检出数目≥12枚的患者比例较对照组高,差异均有统计学意义(均P<0.05);两组平均阳性淋巴结检出数目及淋巴结转移患者比例比较差异均无统计学意义(均P>0.05)。两组吻合口漏、吻合口出血、吻合口狭窄、吻合口周围脓肿发生率比较差异均无统计学意义(均P>0.05)。结论经肛门镜引导于直肠黏膜下层注射纳米炭混悬注射液是一种安全、简便、易于操作的方法,可增加新辅助治疗后中低位直肠癌手术标本淋巴结检出数目,同时不增加吻合口相关并发症。Objectives To investigate the effect of submucosal injection of carbon nanoparticles on the lymph node yield and anastomosis safety after neoadjuvant therapy for mid-and low rectal cancer.Methods We analyzed clinical data from 72 pa⁃tients with mid-and low rectal cancer treated at the First Affiliated Hospital of Guangzhou University of Chinese Medicine be⁃tween January 2017 and January 2021.All patients received sphincter-preserving radical resection after neoadjuvant therapy.Thir⁃ty-one patients received submucosal injection of carbon nanoparticles at 2 cm above the dentate line guided by anoscope 24 hours before surgery(treatment group).Forty-one patients who did not receive submucosal injection were included in the control group.Lymph node yield and complications related to anastomosis were compared between the two groups.Results The treat⁃ment group had significantly more lymph node yield,and greater proportion of patients had lymph nodes≥12 retrieved(P<0.05).The average number of positive lymph nodes and proportions of patients with lymph node metastasis did not differ between the two groups(P>0.05).Incidence of anastomotic leakage,anastomotic bleeding,anastomotic stricture,and peri-anastomotic abscess did not differ between the two groups(P>0.05).Conclusion Submucosal injection of carbon nanoparticles guided by anoscope is a safe,simple,and easy-to-perform procedure.It can improve lymph node yield without increasing the risk of complications relat⁃ed to anastomosis for mid-and low rectal cancer surgery after neoadjuvant therapy.

关 键 词：中低位直肠癌 纳米炭混悬注射液 淋巴结检出数目 吻合口相关并发症 新辅助治疗 

分 类 号：R735.37[医药卫生—肿瘤]