Shen Shuai, Gao Hui, Cao Zhongzheng, Xia Wenlong, Li Chengren
Department of Colorectal and Anal Surgery, Weifang People's Hospital, 151# Guangwen Street, Weifang, Shandong Province, 261000, People's Republic of China.
Qingdao University, Qingdao, People's Republic of China.
Int J Colorectal Dis. 2025 Aug 19;40(1):182. doi: 10.1007/s00384-025-04982-y.
To explore the impact of using nano-carbon suspension for lymph node tracing on the number of detected lymph nodes and short-term clinical outcomes in patients undergoing laparoscopic radical resection for rectal cancer following neoadjuvant therapy.
This study retrospectively analyzed clinical data from 109 patients who underwent neoadjuvant therapy and laparoscopic radical resection for rectal cancer at Weifang People's Hospital from January 2020 to December 2022. Of these, 43 patients received an endoscopic submucosal injection of nano-carbon suspension (experimental group), with 22 patients receiving the injection before neoadjuvant therapy and 21 patients receiving it 24 h before surgery. The remaining 66 patients did not receive the nano-carbon injection (control group). All patients received neoadjuvant therapy according to guidelines and were operated on by the same surgical team. By comparing the number of detected lymph nodes and short-term clinical outcomes among the three groups, the study aimed to investigate the impact of the endoscopic submucosal injection of nano-carbon and the timing of injection on the surgical quality for patients with rectal cancer undergoing neoadjuvant therapy.
The number of detected lymph nodes in the groups injected with nano-carbon before neoadjuvant therapy and 24 h before surgery was significantly higher than that in the non-injected group (P = 0.000), with a significant increase in the proportion of detecting ≥ 12 lymph nodes (P = 0.016), showing statistical significance. There is no statistically significant difference in the number of detected lymph nodes between the group injected with nano-carbon before neoadjuvant therapy and the group injected 24 h before surgery (P = 0.141).
Endoscopic submucosal injection of nano-carbon suspension for lymph node tracing can increase the number of detected lymph nodes in rectal cancer surgery following neoadjuvant therapy, enabling more precise postoperative tumor staging. Although pre-neoadjuvant nano-carbon injection yielded a numerically higher lymph-node detection rate, this trend was not statistically significant (P = 0.141). Consequently, the optimal injection timing remains unconfirmed and should be validated in larger prospective studies.
探讨纳米碳混悬液用于淋巴结示踪对新辅助治疗后接受腹腔镜直肠癌根治术患者的淋巴结检出数量及短期临床结局的影响。
本研究回顾性分析了2020年1月至2022年12月在潍坊市人民医院接受新辅助治疗及腹腔镜直肠癌根治术的109例患者的临床资料。其中，43例患者接受内镜下黏膜下注射纳米碳混悬液（实验组），22例患者在新辅助治疗前注射，21例患者在手术前24小时注射。其余66例患者未接受纳米碳注射（对照组）。所有患者均按照指南接受新辅助治疗，并由同一手术团队进行手术。通过比较三组患者的淋巴结检出数量及短期临床结局，本研究旨在探讨内镜下黏膜下注射纳米碳及注射时机对接受新辅助治疗的直肠癌患者手术质量的影响。
新辅助治疗前及手术前24小时注射纳米碳的组中，淋巴结检出数量显著高于未注射组（P = 0.000），检出≥12枚淋巴结的比例显著增加（P = 0.016），差异具有统计学意义。新辅助治疗前注射纳米碳的组与手术前24小时注射纳米碳的组之间，淋巴结检出数量无统计学差异（P = 0.141）。
内镜下黏膜下注射纳米碳混悬液用于淋巴结示踪可增加新辅助治疗后直肠癌手术的淋巴结检出数量，使术后肿瘤分期更精确。虽然新辅助治疗前注射纳米碳的淋巴结检出率在数值上更高，但这一趋势无统计学意义（P = 0.141）。因此，最佳注射时机仍未确定，应在更大规模的前瞻性研究中进行验证。
