直肠上动脉插管注射美蓝染色在直肠癌根治术中的应用

目的探讨直肠上动脉插管注射美蓝对直肠癌根治术中全直肠系膜切除(TME)的指示作用及淋巴结染色后清除数的变化. 方法对我科2002年1月～2003年12月行直肠癌手术的53例病人,随机选择25例术中经直肠上动脉插管注射美蓝6 ml,另28例行普通根治,观察淋巴结清除情况. 结果注射美蓝组患者直肠系膜染色良好,骶前间隙界限清楚,无输尿管损伤及骶前静脉丛损伤,淋巴结检出数明显高于对照组(P<0.05). 结论直肠癌术中经直肠上动脉插管注射美蓝能清楚显示直肠系膜,避免输尿管和骶前静脉丛的损伤,同时能提高系膜淋巴结检出数,便于病理分期.

The Application of Staining with Methylthioninium Chloride Injected into Superior Rectal Artery in Radical Operation of Rectal Cancer

Objective To discuss the indicate effects of staining with methylthioninium chloride injected into superior rectal arteries in total mesenrectal exicion (TME) of radical operations for rectal cancer and the change of numbers in the eliminated lymph nodes between the patients with and without staining during the operations. Method 25 cases were randomly selected from 53 patients suffered from rectal cancers between January 2002 to December 2003, in whom 6 ml of methylthioninium chloride was injected into superior rectal arteries during radical operations, while the rest 28 cases were performed common radical operations without staining. The staining effect of the mesorectums, lymph nodes and the eliminated lymph nodes were observed. Result In the staining group, the staining effects on mesorectums and lymph nodes were well enough and the presacral space was clear. No presacral venous or plexus ureteral injury occurred in the 25 cases. The average number of eliminated lymph nodes was obviously more than those in controls (P<0.05). Conclusion The mesorectums can be showed clearly by injecting methylthioninium chloride into superior rectal arteries in radical operations for rectal cancers. This procedure can avoid ureteral and the presacral venous plexus injuries during the operations and increase detectable number of lymph nodes to definite pathological stage.