The application of various carbon nanoparticle injection methods in sentinel lymph node mapping for colorectal cancer.

OBJECTIVES

This study aims to investigate the application strategy of "single point-point pressure method" and multi-point injection techniques for carbon nanoparticle injection in laparoscopic radical resection of rectal cancer. The focus is on evaluating the efficacy and efficiency of both methods in sentinel lymph node mapping and tumor localization.

PATIENTS AND METHODS

A prospective analysis was conducted on a total of 119 rectal cancer cases treated our center from January 2020 to December 2021. The cases were divided into two groups: multi-point group and single-point group. In the multi-point group, multiple points of 1:1 diluted nano-carbon suspension were injected into the submucosa around the lesions. In the single-spot group, the tumor lesions were identified using electronic colonoscopy, followed by manual pressure applied to the corresponding abdominal wall. A single point of the stock solution of nano-carbon suspension was injected into the submucosa around the lesions upon observing the external pressure "bouncing sign" under the microscope.

RESULTS

No significant differences were observed between the multi-point group and the single-point group in terms of the number of detected lymph nodes, lesion location, distal resection margin (time to locate the tumor), carbon nanoparticles injection spatter event, operation time for middle and high rectal cancer, intraoperative blood loss, and postoperative exhaust time (P > 0.05). However, the injection time of nano-carbon and operation time for low rectal cancer were significantly shorter in the single point group, with statistically significant differences observed between the two groups (P < 0.05).

CONCLUSIONS

Identifying the distal resection margin clinically contributes to reducing operation time, simplifying surgical procedures, and enhancing efficiency. Sentinel lymph node mapping is crucial in colorectal cancer as it helps in accurate staging and treatment planning. This study aligns with previous research highlighting the effectiveness of carbon nanoparticles in improving lymph node detection and reducing operative time. In addition, this study contributes to the literature by demonstrating the efficiency of the "single point-point pressure method" in laparoscopic radical resection of rectal cancer, offering a simpler and faster alternative to multi-point injection techniques.