腹腔镜胃癌根治术无瘤技术的应用研究

目的:探讨应用无瘤技术后腹腔镜下胃癌根治术对肿瘤脱落细胞的影响，评价其安全性及可行性。方法:收集65例行腹腔镜胃癌手术患者切除前后腹腔冲洗液，细胞学检测腹腔游离癌细胞，并以流式细胞学(FCM)方法检测腹腔冲洗液癌胚抗原(CEA)及基质金属蛋白酶-7（MMP-7)，对比术前、术后检出率。结果:65例规范无瘤操作的腹腔镜胃癌根治术患者腹腔游离癌细胞术前、术后检出率分别为6.15%（4/65）和9.23%（6/65），CEA检测阳性率术前、术后分别为46.2%（30/65）和52.3%（34/65），MMP-7检测阳性率术前、术后分别为56.9%（37/65）和 64.6%(42/65)，术后较手术前高，但两者差异无统计学意义（P>0.05）。结论:严格遵守无瘤操作规程的腹腔镜胃癌根治术，不增加癌细胞的脱落，也不增加腹腔种植转移几率，是安全可行的。

The application of laparoscopic gastric cancer radical disease-free technology

Objective:To explore the application of laparoscopic gastric cancer after radical disease-free technology,evaluate the safety and feasibility.Methods:Collect 65 patients with gastric cancer underwent laparoscopic surgical resection in before and after abdominal rinses，cytological examination intraperitoneal free cancer cells，fluid cytology (FCM） method in detecting celiac rinses carcinoembryonic antigen (CEA） and matrix metalloproteinases-7 (MMP-7)，compare the preoperative and postoperative detection rate.Results:In 65 cases of specification disease-free laparoscopic operation intraperitoneal free cancer cells in patients with preoperative and postoperative gastric cancer radical detection rate was 6.15%(4/65） and 9.23%(6/65)，CEA detection rate of preoperative and postoperative were 46.2%(30/65） and 52.3%(34/65)，MMP-7 detection rate of preoperative and postoperative were 56.9%(37/65） and 64.6%(42/65)，higher than before the operation，but there was no statistically significant difference between the two (P>0.05).Conclusion:Strictly operation rules on disease-free，laparoscopic gastric cancer radical shedding not increase cancer cells，nor increase abdominal planting transfer probability，is safe and feasible.