腹腔镜技术联合纳米炭示踪技术应用于进展期胃癌根治术淋巴结清扫的研究
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摘要
目的探讨进展期胃癌患者的治疗联合运用腹腔镜微创技术与纳米炭示踪技术,评估其提高淋巴结清扫率的临床价值。方法选取2014―2015年该院符合TNM分期标准的64例进展期胃癌患者,随机分为试验组和对照组,各32例。2组患者均施行腹腔镜胃癌D2根治术,试验组注射纳米炭混悬注射液(CNSI),对照组不注射任何药物。记录2组数据并评价术后应用效果。结果 2组在淋巴结清扫数、黑染淋巴结转移数比较,差异有统计学意义(P<0.05);但2组患者的复发率及病死率,差异无统计学意义(P>0.05)。结论 CNSI淋巴靶向性好,示踪能力强,可提高术中对淋巴结的清扫率,联合微创的腹腔镜技术应用于进展期胃癌患者,能改善患者预后。
Objective To explore the clinical value of combination of minimally invasive laparoscopic technique and nano-carbon tracing technique(CNSI)to treat patients with advanced gastric cancer,evaluate the effect on lymph node dissection rate.Methods Sixty-four patients with advanced gastric cancer who met the TNM staging criteria were selected as the study subjects and randomly divided into two groups.D2 radical laparoscopic gastrostomy was performed on all patients in the experimental group and the control group.In the experimental group,CNSI was injected.The control group was not injected with any drugs.Data to evaluate the difference in post-operative effects were record.Results The number of lymph node dissection and blackstained lymph nodes were significantly different between the two groups(P<0.05).The recurrence rate and mortality between the experimental group and the control group were not statistically different(P>0.05).Conclusion CNSI has good lymphatic targeting and strong tracing ability,which could increase the rate of lymph node dissection during operation.Combined with minimally invasive laparoscopic techniques,it can be used in patients with advanced gastric cancer to improve their prognosis.
Objective To explore the clinical value of combination of minimally invasive laparoscopic technique and nano-carbon tracing technique(CNSI)to treat patients with advanced gastric cancer,evaluate the effect on lymph node dissection rate.Methods Sixty-four patients with advanced gastric cancer who met the TNM staging criteria were selected as the study subjects and randomly divided into two groups.D2 radical laparoscopic gastrostomy was performed on all patients in the experimental group and the control group.In the experimental group,CNSI was injected.The control group was not injected with any drugs.Data to evaluate the difference in post-operative effects were record.Results The number of lymph node dissection and blackstained lymph nodes were significantly different between the two groups(P<0.05).The recurrence rate and mortality between the experimental group and the control group were not statistically different(P>0.05).Conclusion CNSI has good lymphatic targeting and strong tracing ability,which could increase the rate of lymph node dissection during operation.Combined with minimally invasive laparoscopic techniques,it can be used in patients with advanced gastric cancer to improve their prognosis.
引文
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[12]吴晖,王亮,何裕隆,等.淋巴结转移阳性早期胃癌的临床病理特征及淋巴结清扫范围对患者预后的影响[J].中华肿瘤杂志,2013,35(7):509-513.
[13]朱乐意,李树峰,徐峰.不同部位胃癌临床病理特征及预后因素对比分析[J].中国实用医刊,2016,43(3):7-9.
[14]徐龙帅,陈晓鹏.胃癌淋巴结清扫范围的现状与进展[J].肿瘤基础与临床,2010,23(2):181-183.
[15]TIAN W G,JIANG Y,GAO B,et al.Application of nanocarbon in lymph node dissection for thyroid cancer and protection of parathyroid glands[J].Med Sci Monit,2014,20(24):1925-1930.
[16]葛现才,张勤,徐宪辉,等.纳米炭示踪技术在结肠癌根治术淋巴结清扫中应用价值研究[J].中国实用外科杂志,2016,36(8):904-906.
[17]洪强,汪勇,王建军,等.术前胃镜下注射法纳米碳淋巴结示踪技术在腹腔镜胃癌根治术中的应用[J].中华医学杂志,2017,97(2):123-126.
[18]段绪伟,李真龙,许坚.纳米炭示踪剂在甲状腺癌根治术中的应用[J].中国普通外科杂志,2015,24(5):638-642.
[19]GAO Y S,SUN J G,HUANG J J,et al.Gao′s doubleway approach for laparoscopic D2radical surgery for gastric cancer[J].World J Gastrointest Surg,2016,8(6):424-426.
[20]JIA R B,JIANG L X,YAO Z W,et al.Clinical study on carbon nanoparticle tracer guided tiny lymph nodes dissection in laparoscopic gastrectomy[J].J Laparoscopic Surg,2018,48(21):672-676.
[2]ZHAO X Z,RONG S Z,SI W Z,et al.An analysis of incidence and mortality of stomach cancer in China,2010[J].Tumor,2014,32(2):3456-3458.
[3]ZHANG J J,WANG J,HU W Q.Current status and research progress of lymph node dissection in advanced upper gastric cancer[J].Zhonghua Wei Chang Wai Ke Za Zhi,2018,21(2):236-240.
[4]张志谦.腹腔镜胃癌根治术及TNM分期对肿瘤细胞腹腔转移的影响[J].贵阳医学院学报,2015,40(11):1269-1271.
[5]LIN W,LI Z,XU Y,et al.Comparative study of laparoscopic gastrectomy D2radical surgery and open gastrectomy for upper stomach cancer[J].Cancer Res Clin,2014,26(5):332-335.
[6]ZHU G Y,FENG M Y,YAN F L,et al.Clinical analysis of laparoscopic-assisted and open radical surgery for gastric cancer[J].Prog Modern Biomed,2017,45(12):2124-2126.
[7]YE F,ZHAO Y,EI-SAYED R,et al.Advances in nanotechnology for cancer biomarkers[J].Nano Today,2018,18(6):103-123.
[8]程科,庄競,李保东,等.纳米碳淋巴示踪剂在腹腔镜辅助下进展期胃癌根治术中的应用及评价[J].中国普外基础与临床杂志,2016(12):1460-1463.
[9]VENERITO M,LINK A,ROKKAS T A.Gastric cancerclinical and epidemiological aspects[J].Helicobacter,2016,21(SI):39-44.
[10]刘国栋,李晓波,李昌荣,等.早期胃癌淋巴结转移的研究进展[J].中华消化外科杂志,2016,15(1):93-96.
[11]魏秋亚,樊勇,刘永永,等.纳米炭示踪技术在腹腔镜进展期胃癌根治术中的临床应用[J].中国微创外科杂志,2016,16(12):1113-1116.
[12]吴晖,王亮,何裕隆,等.淋巴结转移阳性早期胃癌的临床病理特征及淋巴结清扫范围对患者预后的影响[J].中华肿瘤杂志,2013,35(7):509-513.
[13]朱乐意,李树峰,徐峰.不同部位胃癌临床病理特征及预后因素对比分析[J].中国实用医刊,2016,43(3):7-9.
[14]徐龙帅,陈晓鹏.胃癌淋巴结清扫范围的现状与进展[J].肿瘤基础与临床,2010,23(2):181-183.
[15]TIAN W G,JIANG Y,GAO B,et al.Application of nanocarbon in lymph node dissection for thyroid cancer and protection of parathyroid glands[J].Med Sci Monit,2014,20(24):1925-1930.
[16]葛现才,张勤,徐宪辉,等.纳米炭示踪技术在结肠癌根治术淋巴结清扫中应用价值研究[J].中国实用外科杂志,2016,36(8):904-906.
[17]洪强,汪勇,王建军,等.术前胃镜下注射法纳米碳淋巴结示踪技术在腹腔镜胃癌根治术中的应用[J].中华医学杂志,2017,97(2):123-126.
[18]段绪伟,李真龙,许坚.纳米炭示踪剂在甲状腺癌根治术中的应用[J].中国普通外科杂志,2015,24(5):638-642.
[19]GAO Y S,SUN J G,HUANG J J,et al.Gao′s doubleway approach for laparoscopic D2radical surgery for gastric cancer[J].World J Gastrointest Surg,2016,8(6):424-426.
[20]JIA R B,JIANG L X,YAO Z W,et al.Clinical study on carbon nanoparticle tracer guided tiny lymph nodes dissection in laparoscopic gastrectomy[J].J Laparoscopic Surg,2018,48(21):672-676.