[1]魏秋亚,樊勇,刘永永,等.纳米炭示踪技术在腹腔镜进展期胃癌根治术中的临床应用[J].中国微创外科杂志,2016,16(12):1113-1116.
 Wei Qiuya,Fan Yong,Liu Yongyong,et al.Clinical Study on Carbon Nanoparticles Tracer Technique Guided Laparoscopic Radical Resection of Advanced Gastric Cancer[J].Chinese Journal of Minimally Invasive Surgery,2016,16(12):1113-1116.
点击复制

纳米炭示踪技术在腹腔镜进展期胃癌根治术中的临床应用()
分享到:

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
16
期数:
2016年12期
页码:
1113-1116
栏目:
临床研究
出版日期:
2016-12-20

文章信息/Info

Title:
Clinical Study on Carbon Nanoparticles Tracer Technique Guided Laparoscopic Radical Resection of Advanced Gastric Cancer
作者:
魏秋亚樊勇刘永永王芙蓉①李徐生周信远陈小鹏王跃斌王琛**
兰州大学第二医院微创外科,兰州730000
Author(s):
Wei Qiuya Fan Yong Liu Yongyong et al.
Department of Minimally Invasive Surgery, Second Affiliated Hospital of Lanzhou University, Lanzhou 730000, China
关键词:
纳米炭混悬注射液腹腔镜进展期胃癌
Keywords:
Carbon nanoparticles suspension injectionLaparoscopyAdvanced gastric cancer
文献标志码:
A
摘要:
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。
Abstract:
ObjectiveTo explore the clinical value of carbon nanoparticles tracer technique guided laparoscopic radical resection of advanced gastric cancer.MethodsA retrospective analysis was made on clinical data of 180 cases of gastric cancer treated from January 2014 to June 2015. We selected 60 cases who were successfully performed laparoscopic D2 radical gastrectomy, including 30 cases receiving nanocarbon tracer as the experimental group and 30 cases without nanocarbon tracer as the control group. The experimental group was given carbon nanoparticles suspension injection (Canari) during the operation, whereas the control group did not receive any drug injection. The number and diameter of lymph nodes were detected after the sample was isolated. The rate of black stain and metastasis rate of lymph nodes were compared statistically. ResultsIn the experimental group, the total number of lymph node dissection was significantly more than that in the control group[(38.9±7.4) vs. (28.7±6.1), t=5.826, P=0.000], and the number of lymph nodes whose diameter were less than 2 mm was significantly more than that in the control group [(8.3±39) vs. (5.8±3.3), t=2.680, P=0.010]. The number of lymph node metastasis was 10.4±3.6 in the experimental group, which was significantly higher than that in the control group (5.6±2.8, t=5.765, P=0.000). The experimental group had a number of black stained lymph node of 632, with a staining rate of 54.1% (632/1168) and a black stained lymph node metastasis rate of 23.3% (147/632), which were significantly higher than the control group with respect to the metastasis rate [14.4%(124/860), χ2=19155, P=0.000] and non-stained lymph node metastasis rate [12.3%(66/536), χ2=23.305, P=0.000].ConclusionApplication of carbon nanoparticles tracer technique in laparoscopic radical resection of advanced gastric cancer can obtain more lymph nodes dissected, with improved rates of small lymph node and positive lymph node dissection.

参考文献/References:

[1]Alatengbaolide, Lin D, Li Y, et al. Lymph node ratio is an independent prognostic factor in gastric cancer after curative resection (R0) regardless of the examined number of lymph nodes. Am J Clin Oncol,2013,36(4):325-330.
[2]刘汇明,马荣梅,丁洪华,等.纳米炭在胃癌根治术中的临床应用价值.中国现代普通外科进展,2014,17(3):229-230.
[3]吴在德,主编.外科学.第7版.北京:人民卫生出版社,2010.439.
[4]曹永宽,刘立业,罗国德,等.手助腹腔镜行胃癌D2根治术的手术安全与技术路径探讨.中国普通外科杂志,2012,21(4):373-376.
[5]万远廉,潘义生,刘玉村,等.胃癌淋巴转移规律与淋巴结清扫范围的分析(附326例报告).中华外科杂志,2000,38(10):752-755.
[6]李医明,刘彩刚,王斌斌,等.淋巴结转移率对胃癌患者预后的评估价值.中华胃肠外科杂志,2012,15(2):137-140.
[7]De Steur WO, Hartgrink HH, Dikken JL, et al. Quality control of lymph node dissection in the Dutch Gastric Cancer Trial.Br J Surg,2015,102(11):1388-1393.
[8]Melis M, Masi A, Pinna A, et al. Does lymph node ratio affect prognosis in gastroesophageal cancer Am J Surg,2015,210(3):443-450.
[9]刘颖斌,吴文广.早期胃癌的淋巴转移及胃癌术中淋巴结清扫的相关问题.实用肿瘤杂志,2010,25(5):511-514.
[10]钱锋,孙刚,唐波,等.腹腔镜胃癌根治手术的学习曲线.中国微创外科杂志,2008,8(6):510-512.
[11]Ohtani H, Tamamori Y, Noguchi K, et al. Meta-analysis of laparoscopy-assisted and open distal gastrectomy for gastric cancer. J Surg Res,2011,171(2):479-485.
[12]刘汇明,马荣梅,丁洪华,等.纳米炭在胃癌根治术中的临床应用价值.中国现代普通外科进展,2014,17(3):229-230.
[13]刘江文,孙琳,仝德峰,等.远端进展期胃癌腹腔镜辅助与开腹D2根治术淋巴结清扫的临床对照研究.中国微创外科杂志,2014,14(11):981-986.
[14]张志栋,刘庆伟,李勇,等.纳米炭淋巴示踪剂在进展期胃癌根治术中的应用价值.中国全科医学,2015,18(3):255-258.

备注/Memo

备注/Memo:
基金项目:2014年度兰州市科技发展计划项目**通讯作者,E-mail:wcdfjack@163.com①病理科
更新日期/Last Update: 2017-03-09