胃肠道病变磁体预标记辅助腹腔镜定位术初探

目的 评估胃肠道病变磁体预标记辅助腹腔镜定位术的可行性及安全性。方法 2019年4月-6月，拟行腹腔镜根治术的胃、结直肠肿瘤住院患者8例，在行腹腔镜切除术前接受了内镜下磁体预标记。术中通过腹腔镜孔道送入另一枚磁体，在磁体相互吸引力导引下，快速与病变附近预标记的磁体隔胃肠道壁而吸引在一起，实现病变定位。采用回顾性分析方法，对8例患者术前标记及手术情况进行分析和总结。结果 8例患者全部术前内镜下成功标记病灶， 并实现了术中快速准确定位。内镜下标记平均用时为5.75±2.45min，术中定位平均用时1.94±0.56min。所有患者均完成腹腔镜肿瘤切除术，定位准确，结直肠肿瘤病灶平均近端和远端切除边缘分别为105和74mm，无不良并发症发生。结论 胃肠道病变磁体预标记辅助腹腔镜定位术简便、安全、准确；同时不增加额外诊治设备、无需消化内镜术中配合操作，大大减少院内感染风险。

Clinical application exploration of magnetic tracer technique in laparoscopic localization of gastrointestinal lesions

Objective Intraoperative localization of gastrointestinal lesions has been an important issue in laparoscopic surgery, we have developed a new magnetic tracer technique for preoperative endoscopic marking. This paper is to evaluate the feasibility and safety of this method. Methods From April to June in 2019, in a preliminary study, 8 patients with gastric (n=3) or colorectal (n = 5) tumors underwent endoscopic magnetic marking before laparoscopic surgery. Now, we report the relevant informations of preoperative marking and operation. Results All 8 lesions were marked successfully in endoscopy center by clapping magenets. In subsequent laparoscopic surgery, the other magnets inserted into the abdominal cavity were quickly combined with the magnets in the gastrointestinal tract to successfully locate the lesions. The average time of endoscopic marking was 5.75±2.45 minutes, and the average time of intraoperative localization was 1.94±0.56 minutes. All patients underwent laparoscopic tumor resections with accurate localization. The average proximal and distal resection margins of colorectal tumors were 105 and 74 mm respectively. No adverse complications occurred. Conclusion Magnetic tracer technique of gastrointestinal lesions is simple and safe for laparoscopic localization, which not only can be performed without additional equipment, but has a series of advantages, such as accurate localization, less intraoperative cooperation and fewer hospital infection.