文章摘要

纳米碳示踪技术在腹腔镜结肠癌根治术中的应用

作者: 1,2葛现才, 1周岩冰, 2徐宪辉, 2刘伟静, 3刘青, 2张勤
1 青岛大学医学院 普通外科,山东 青岛 266071
2 中国人民解放军第四〇一医院普通外科,山东 青岛 266071
3 中国人民解放军第四〇一医院麻醉科,山东 青岛 266071
通讯:
DOI: 10.3978/.10.3978/j.issn.1005-6947.2017.04.015
基金: 山东省青岛市公共领域科技支撑计划资助项目, 2014-14-036-YY

摘要

目的:纳米碳示踪技术在腹腔镜结肠癌根治术中的应用价值。方法:将35例结肠癌患者随机分为研究组(15例)和对照组(20例),研究组在行肿瘤组织周围黏膜或浆膜下纳米碳注射后行腹腔镜结肠癌根治术,对照组直接行腹腔镜手术,比较两组相关临床指标及淋巴结检出情况。结果:研究组与对照组的手术切口总长度、肛门排气时间、术后进食时间、住院时间差异均无统计学意义(均P>0.05),但研究组的手术时间与术中出血量明显低于对照组(均P<0.05)。两组除肠旁组淋巴结获取数目上差异无统计学意义外(P=0.078),研究组在淋巴结清扫总数目、<5 mm淋巴结数目、阳性淋巴结数目方面均优于对照组(均P<0.05)。结论:腹腔镜结肠癌根治术中联合纳米碳淋巴示踪技术,能弥补腹腔镜手术触觉感的不足,做到了微创与精准并重,明显提高淋巴结检出率。
关键词: 结肠肿瘤 腹腔镜 着色剂 纳米粒子 淋巴结切除术

Application of carbon nanoparticle tracer technique in radical laparoscopic colon cancer surgery

Authors: 1,2GE Xiancai, 1ZHOU Yanbing, 2XU Xianhui, 2LIU Weijing, 3LIU Qing, 2ZHANG Qin
1 Department of General Surgery, Affiliated Hospital, Qingdao University, Qingdao, Shangdong 266071, China
2 Department of General Surgery, No.401 Hospital of People’s Liberation Army, Qingdao, Shangdong 266071, China
3 Department of Anesthesia, No.401 Hospital of People’s Liberation Army, Qingdao, Shangdong 266071, China

Abstract

Objective: To determine the value of using carbon nanoparticle tracer in radical laparoscopic colon cancer surgery. Methods: Thirty-five patients with colon cancer were randomly designated to study group (15 cases) and control group (20 cases). Patients in study group underwent submucosal or subserosal injection of carbon nanoparticles around the tumor prior to radical laparoscopic colon cancer surgery, while those in control group underwent laparoscopic surgery directly. The main clinical variables and lymph node detection were compared between the two groups. Results: There was no statistical difference in length of incision, time to gas passage, time to postoperative food intake and length of hospital stay between the two groups (all P>0.05), but the operative time and intraoperative blood loss were significantly reduced in study group compared with control group (both P<0.05). Except the number of dissected paracolic lymph nodes that showed no statistical difference between the two groups (P=0.078), the total number of dissected lymph nodes, the number of lymph nodes <5 mm and number of positive lymph nodes in study group were all superior to those in control group (all P<0.05). Conclusion: In radical laparoscopic colon cancer surgery, using carbon nanoparticle tracer technique can overcome the lack of tactile sense in the process of laparoscopic surgery, allow the combination of minimal invasiveness and precision, and significantly improve the lymph node detection rate.
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