纳米炭示踪剂在进展期胃癌根治术中应用

目的探讨术中淋巴结示踪定位技术对进展期胃癌淋巴清扫的指导作用。方法术中肿瘤周围注射第三代淋巴结示踪剂—纳米炭混悬液,在D2根治术的基础上以黑染淋巴结为导向进行个体化清扫。统计清扫淋巴结的数目及淋巴结转移情况、黑染情况,并观察不良反应及并发症的发生。结果本组平均每例清扫淋巴结(26.2±12.1)枚,其中阳性淋巴结(7.1±2.3)枚;淋巴结黑染率为54.3%,黑染淋巴结中发生转移的阳性率32.4%,高于未黑染淋巴结13.1%,差异有统计学意义(P<0.05)。结论进展期胃癌在D2根治术的基础上以术中淋巴显影技术为指导进行个体化清扫,能增加淋巴结清扫的彻底程度,并可提高清扫转移淋巴结的效率,但肿瘤进展程度会影响淋巴显影效果。

The clinical study on the sentinel lymph node of advanced gastric cancer by carbon nano particles suspension injection

Objective To evaluate the clinical application of nano - carbon in visualization of sentinel lymph node （SLN） in advanced gastric cancer surgery. Methods Nano-carbon was injected into the subserosa around the tumor for lymphatic tracing before operation. The number of lymph nodes dissected, the number of metastatic lymph node and the number of blacken lymph node of patients were counted. Results The number of lymph nodes dissected in patients was 26.2 ± 12.1 ,which has 7.1 ± 2.3 metastatic lymph node. The rate of blacken lymph node of patients was 54.3%. The blacken rate of metastatic lymph nodes was 32.4% ,which was significantly higher than the non- blacken rate of metastatic lymph nodes （ 13.1% ）, P 〈 0.05. Conclusions Subserosal injection of nano-carbon particles around the tumor can provide the guidance to lymph node dissection in radical gastrectomy.