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目的:应用纳米碳微粒作为淋巴结示踪剂,评价手助腹腔镜胃癌根治术中淋巴结清扫的规范性。方法:回顾性分析8个月内实施手助腹腔镜胃癌根治术患者40例的临床资料。将手术中注射纳米碳混悬液后进行淋巴结清扫的患者15例设为观察组,其余25例为对照组。结果:观察组15例中,小弯侧淋巴结显色12例(80.00%);8a组和6组淋巴结色染各8例(53.33%);脾门和大弯侧淋巴结色染各3例(20.00%)。观察组与对照组的主要手术相关指标,包括切口长度[(6.90±0.28)cm vs.(6.82±0.38)cm],术中出血量[(286±168)mL vs.(235±98)mL],手术时间[(182±31)min vs.(176±21)min],淋巴结检出数[(16.8±6.71)枚vs.(14.9±3.90)枚],术后住院时间[(10.1±3.8)d vs.(11.6±6.5)d],差异均无统计学意义(均P>0.05)。结论:淋巴结示踪剂的应用,对完善术中淋巴结清扫有一定的辅助作用;更能体现出手助腹腔镜胃癌根治术淋巴结清扫的规范性。
OBJECTIVE: To evaluate the standardization of lymph node dissection in hand-assisted laparoscopic radical gastrectomy using carbon nano-particles as a lymph node tracer. Methods: The clinical data of 40 patients who underwent hand-assisted laparoscopic radical gastrectomy within 8 months were retrospectively analyzed. Fifteen patients with lymph node dissection after intraoperative injection of nanocarbon suspension were selected as observation group and the remaining 25 as control group. Results: In the observation group, 12 cases (80.00%) were found in 15 cases of small bended lymph nodes, 8 cases (53.33%) in 8 cases and 6 cases, and 3 cases of splenomegaly and meibomian lymph node staining 20.00%). The main operative parameters of the observation group and the control group included incision length [(6.90 ± 0.28) cm vs. (6.82 ± 0.38) cm], intraoperative blood loss (286 ± 168 mL vs. 235 ± 98 mL (182 ± 31) min vs. 176 ± 21 min, and the number of lymph nodes was (16.8 ± 6.71) vs. (14.9 ± 3.90). The length of postoperative hospital stay was (10.1 ± 3.8) d vs. (11.6 ± 6.5) d], respectively, with no significant difference (all P> 0.05). Conclusion: The application of lymph node tracer can improve the operation of lymphadenectomy. It can better reflect the normative of hand-assisted laparoscopic radical gastrectomy for lymph node dissection.