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目的探讨胃癌根治术中应用纳米炭作为示踪剂指导个体化淋巴结清扫的可行性和临床效果。方法回顾性分析术中注射纳米炭行胃癌D2(部分D2+)根治术的111例患者围术期资料(研究组),取同期未应用纳米炭示踪行常规胃癌D2(部分D2+)根治术的106例患者作为对照组,比较两组患者手术时间、术中出血量、住院时间、清扫淋巴结个数并详细分组(N1、N2、部分N3淋巴结)、转移淋巴结个数。结果两组患者手术时间、术中出血量、住院时间比较均无统计学差异(均P<0.05)。两组患者术中清扫的淋巴结情况比较,除外N1淋巴结,研究组患者清扫、转移淋巴结,N2、部分N3淋巴结,微小N1、N2、部分N3淋巴结个数均大于对照组(均P<0.05)。结论在胃癌根治术中应用纳米炭示踪剂简单、可行,可指导个体化淋巴结的清扫范围,增加转移淋巴结检出率,利于临床作出准确的肿瘤分期,指导术后化疗方案的制定。
Objective To investigate the feasibility and clinical effect of using nano-carbon as tracer in the radical operation of gastric cancer to guide individual lymph node dissection. Methods We retrospectively analyzed the perioperative data of 111 patients with D2 (partial D2 +) radical resection of gastric cancer treated by intraoperative carbon nanocarbon injection. We did not use the carbon nanotube tracing for D2 (partial D2 +) radical resection of conventional gastric cancer during the same period One hundred and sixty-six patients served as control group. The operation time, blood loss, length of hospital stay, the number of lymph nodes dissected and the number of lymph nodes dissected (N1, N2 and some N3 lymph nodes) were compared between the two groups. Results There was no significant difference in operation time, intraoperative blood loss and hospital stay between the two groups (all P <0.05). The number of dissected lymph nodes, N2, some N3 lymph nodes, N1, N2 and some N3 lymph nodes in the study group were significantly larger than those in the control group (all P <0.05). Conclusion The application of nanocarbon tracers in radical resection of gastric cancer is simple and feasible, which can guide the cleaning range of individualized lymph nodes, increase the detection rate of metastatic lymph nodes, facilitate the accurate clinical staging of tumors, and guide the formulation of postoperative chemotherapy regimens.