论文部分内容阅读
目的探讨纳米炭示踪技术应用于腹腔镜下进展期胃癌根治术淋巴结清扫的临床价值。方法回顾分析我科2014年1月~2015年6月186例胃癌的临床资料,选择成功完成腹腔镜下远端胃癌D2根治术60例,其中纳米炭示踪剂30例为实验组,未用纳米炭示踪剂30例为对照组。实验组在手术过程中应用纳米炭混悬注射液(卡纳琳),对照组不给予任何药剂注射。比较2组标本离体后检获淋巴结数目和转移率。结果实验组清扫淋巴结(38.9±7.4)枚,明显多于对照组(28.7±6.1)枚(t=5.826,P=0.000),其中清扫直径≤2 mm淋巴结(8.3±3.9)枚,明显多于对照组(5.8±3.3)枚(t=2.680,P=0.010);实验组转移淋巴结(10.4±3.6)枚,明显多于对照组(5.6±2.8)枚(t=5.765,P=0.000)。实验组黑染淋巴结数目632枚,黑染率54.1%(632/1168),黑染淋巴结转移率23.3%(147/632),明显高于对照组淋巴结转移率14.4%(124/860,χ2=19.155,P=0.000)和未黑染淋巴结转移率12.3%(66/536,χ2=23.305,P=0.000)。结论纳米炭淋巴示踪剂应用于进展期胃癌淋巴结清扫可清扫较多的淋巴结,提高小淋巴结及阳性淋巴结的清扫率。
Objective To investigate the clinical value of nanocarbon tracer technique applied in laparoscopic radical lymph node dissection of advanced gastric cancer. Methods The clinical data of 186 cases of gastric cancer from January 2014 to June 2015 in our department were retrospectively analyzed. Sixty cases of distal gastric cancer D2 underwent laparoscopic radical resection were successfully treated. Among them, 30 cases of carbon-tracer were used as experimental group, Nano-carbon tracer 30 cases for the control group. In the experimental group, nanocarbon suspension injection (Kanalin) was used during the operation, while the control group did not receive any drug injection. The number of lymph nodes and the metastasis rate were compared between the two groups. Results The number of lymph nodes in the experimental group (38.9 ± 7.4) was significantly higher than that in the control group (28.7 ± 6.1) (t = 5.826, P = 0.000) (5.8 ± 3.3) in the control group (t = 2.680, P = 0.010). The number of metastatic lymph nodes (10.4 ± 3.6) in the experimental group was significantly higher than that in the control group (5.6 ± 2.8) (t = 5.765, P = 0.000). The number of black stained lymph nodes was 632 in the experimental group, with black stained rate of 54.1% (632/1168) and black stained lymph node metastasis rate of 23.3% (147/632), which was significantly higher than that of the control group (14.4%, 124/860, 19.155, P = 0.000) and non-black-stained lymph node metastasis rate 12.3% (66/536, χ2 = 23.305, P = 0.000). Conclusion Nanocarbon lymphatic tracer applied to lymph node dissection in advanced gastric cancer can dissect more lymph nodes and improve the clearance rate of small lymph nodes and positive lymph nodes.