Hong Q, Wang Y, Wang J J, Hu C G, Fang Y J, Fan X X, Liu T, Tong Q
Department of Digestive Surgery, Jinhua Guangfu Hospital, Zhejiang 321000, China.
Zhonghua Yi Xue Za Zhi. 2017 Jan 10;97(2):123-126. doi: 10.3760/cma.j.issn.0376-2491.2017.02.009.
To evaluate the application value of carbon lymph node tracing technique by preoperative endoscopic subserosal injection in laparoscopic radical gastrectomy. From June 2013 to February 2015, seventy eight patients with gastric cancer were enrolled and randomly divided into trial group and control group. Subserosal injection of carbon nanoparticles around the tumor was performed by preoperative endoscopic subserosal injection one day before the operation in trial group, while the patients routinely underwent laparoscopic gastrectomy in control group. Results of harvested lymph nodes, postoperative complications were compared between the two groups. Carbon nanoparticle-related side effect was also evaluated. The average number of harvested lymph node in trial group was significantly higher than that in control group (35.5±8.5 vs 29.5±6.5, <0.05). The rate of overall black-dyed harvested lymph node was 74.7% (1 035/1 386) in trial group, the black-dyed lymph node rate in D1 lymph node was 80.1%, which was significantly higher than that in D2 lymph node (69.8%, χ=19.38, <0.01). When comparing the lymph node with and without black-dyed in trial group, the rate of metastasis lymph node was significantly higher in lymph node with black-dyed (17.3% vs 4.0%, χ=38.67, <0.01). There was no significant difference in postoperative complications rate between two group (trial group 10.2%; control group 12.8%, χ=0.00, >0.05), and no carbon nanoparticle-related side effect was observed. Given a higher harvested lymph node number and a similar rate of complications, preoperative endoscopic subserosal injection of carbon nanoparticles was safe and feasible.
评估术前内镜下浆膜下注射碳纳米颗粒示踪技术在腹腔镜胃癌根治术中的应用价值。2013年6月至2015年2月，纳入78例胃癌患者，随机分为试验组和对照组。试验组于术前1天经内镜在肿瘤周围浆膜下注射碳纳米颗粒，对照组患者常规行腹腔镜胃癌根治术。比较两组的淋巴结收获情况、术后并发症，并评估碳纳米颗粒相关副作用。试验组平均收获淋巴结数显著高于对照组（35.5±8.5 vs 29.5±6.5，P<0.05）。试验组总体黑染淋巴结收获率为74.7%（1035/1386），D1淋巴结黑染率为80.1%，显著高于D2淋巴结（69.8%，χ²=19.38，P<0.01）。试验组比较黑染与未黑染淋巴结，黑染淋巴结转移率显著更高（17.3% vs 4.0%，χ²=38.67，P<0.01）。两组术后并发症发生率无显著差异（试验组10.2%；对照组12.8%，χ²=0.00，P>0.05），且未观察到碳纳米颗粒相关副作用。鉴于试验组收获淋巴结数更多且并发症发生率相似，术前内镜下浆膜下注射碳纳米颗粒安全可行。
