中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
32期
2612-2615
,共4页
张相春%王延磊%晏伟%毛佳佳%王加勇%姜金波%戴勇
張相春%王延磊%晏偉%毛佳佳%王加勇%薑金波%戴勇
장상춘%왕연뢰%안위%모가가%왕가용%강금파%대용
结直肠肿瘤%淋巴转移%纳米碳%腹腔镜
結直腸腫瘤%淋巴轉移%納米碳%腹腔鏡
결직장종류%림파전이%납미탄%복강경
Colorectal neoplasms%Lymphatic metastasis%Carbon nanoparticles%Laparoscopy
目的 探讨纳米碳淋巴示踪剂在腹腔镜结直肠癌根治手术中的临床应用价值.方法 回顾分析2014年3-7月山东大学齐鲁医院结直肠外科53例行腹腔镜结直肠癌根治手术患者的临床资料,其中26例患者于术前1～3d肠镜下肿瘤周围纳米碳注射后再行腹腔镜结直肠癌根治手术(纳米碳组);27例患者直接手术(对照组);分析比较两组淋巴结检出数、微小淋巴结(＜5 mm)数、黑染淋巴结数及淋巴结转移情况.结果 两组一般资料差异均无统计学意义;纳米碳组的淋巴结检出总数434枚,平均(16.7±3.2)枚,对照组总检出数340枚,平均(12.6±2.3)枚,纳米碳组淋巴结检出数明显高于对照组(P＜0.001);纳米碳组微小淋巴结检出数及检出率均明显高于对照组(P＜0.001);纳米碳组检出淋巴结不足12枚比率明显低于对照组(0与33.3％,P=0.001).两组淋巴结阳性率差异无统计学意义(P =0.693).结论 在腹腔镜结直肠癌手术中应用纳米碳淋巴示踪技术有助于指导术中淋巴结清扫,提高淋巴结检出率,减少癌细胞残留,提高术后病理分期的准确性,利于指导术后辅助治疗,具有较高的临床应用价值.
目的 探討納米碳淋巴示蹤劑在腹腔鏡結直腸癌根治手術中的臨床應用價值.方法 迴顧分析2014年3-7月山東大學齊魯醫院結直腸外科53例行腹腔鏡結直腸癌根治手術患者的臨床資料,其中26例患者于術前1～3d腸鏡下腫瘤週圍納米碳註射後再行腹腔鏡結直腸癌根治手術(納米碳組);27例患者直接手術(對照組);分析比較兩組淋巴結檢齣數、微小淋巴結(＜5 mm)數、黑染淋巴結數及淋巴結轉移情況.結果 兩組一般資料差異均無統計學意義;納米碳組的淋巴結檢齣總數434枚,平均(16.7±3.2)枚,對照組總檢齣數340枚,平均(12.6±2.3)枚,納米碳組淋巴結檢齣數明顯高于對照組(P＜0.001);納米碳組微小淋巴結檢齣數及檢齣率均明顯高于對照組(P＜0.001);納米碳組檢齣淋巴結不足12枚比率明顯低于對照組(0與33.3％,P=0.001).兩組淋巴結暘性率差異無統計學意義(P =0.693).結論 在腹腔鏡結直腸癌手術中應用納米碳淋巴示蹤技術有助于指導術中淋巴結清掃,提高淋巴結檢齣率,減少癌細胞殘留,提高術後病理分期的準確性,利于指導術後輔助治療,具有較高的臨床應用價值.
목적 탐토납미탄림파시종제재복강경결직장암근치수술중적림상응용개치.방법 회고분석2014년3-7월산동대학제로의원결직장외과53례행복강경결직장암근치수술환자적림상자료,기중26례환자우술전1～3d장경하종류주위납미탄주사후재행복강경결직장암근치수술(납미탄조);27례환자직접수술(대조조);분석비교량조림파결검출수、미소림파결(＜5 mm)수、흑염림파결수급림파결전이정황.결과 량조일반자료차이균무통계학의의;납미탄조적림파결검출총수434매,평균(16.7±3.2)매,대조조총검출수340매,평균(12.6±2.3)매,납미탄조림파결검출수명현고우대조조(P＜0.001);납미탄조미소림파결검출수급검출솔균명현고우대조조(P＜0.001);납미탄조검출림파결불족12매비솔명현저우대조조(0여33.3％,P=0.001).량조림파결양성솔차이무통계학의의(P =0.693).결론 재복강경결직장암수술중응용납미탄림파시종기술유조우지도술중림파결청소,제고림파결검출솔,감소암세포잔류,제고술후병리분기적준학성,리우지도술후보조치료,구유교고적림상응용개치.
Objective To investigate the value of lymph node labeled with carbon nanoparticles in laparoscopic colorectal cancer resection.Methods The clinical data of 53 patients received laparoscopic radical colorectal surgeries in our department from March 2014 to July 2014 was retrospectively analyzed.Among these patients,carbon nanoparticles were injected into the periphery of the tumor under colonoscopy 1-3 days before the operation (the nanoparticle group) in 26 patients,while 27 patients received operation directly (the control group).The number of cleared lymph nodes,tiny lymph nodes (＜ 5 mm),dyed lymph nodes,and lymph node metastatic rate were compared between the two groups.Results The two groups had no statistical difference in basic characteristics;434 and 340 lymph nodes were dissected in the nanoparticle group and control group respectively.The average number of cleared lymph nodes(16.7 ± 3.2) in the nanoparticle group was significantly higher than that of the control group(12.6 ± 2.3) (P ＜ 0.001).Besides,both the average number and ratio of cleared tiny lymph nodes in the nanoparticle group were significant higher than those of the control group(P ＜ 0.001).Moreover,the rate of less than 12 detected lymph nodes in the nanoparticle group was markedly lower than that of the control group (0 vs 33.3％,P =0.001).There was no statistical difference in lymph node metastatic rate between the two groups (P =0.693).Conclusion Application of lymph node labeled with carbon nanoparticles in laparoscopic colorectal cancer surgery could instruct lymph nodes dissection,improve lymph node detection rate,reduce tumor residual rate,improve the accuracy of pathological staging,and guide the postoperative adjuvant therapy.
