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目的探讨纳米碳淋巴示踪剂在腹腔镜早期胃癌根治术中的临床应用。方法早期远端胃癌患者44例随机分为两组:试验组20例,行纳米碳淋巴示踪剂引导下腹腔镜辅助D2远端胃癌根治术;对照组24例,行常规腹腔镜辅助D2远端胃癌根治术。比较两组患者淋巴结检出数目、淋巴结转移情况、手术时间、术中出血量及病灶与上切缘距离。结果试验组每例清扫淋巴结数目多于对照组[(25.0±4.7)枚vs.(17.0±4.1)枚](P<0.05)。试验组和对照组转移淋巴结检出率差异无统计学意义(1.2%vs.1.0%)(P>0.05)。与对照组比较,试验组患者手术时间短[(188±24)min vs.(216±25)min],术中出血量少[(118±30)ml vs.(148±33)ml],而病灶与上切缘距离大[(3.8±0.9)cm vs.(3.2±1.2)cm](P<0.05)。结论纳米碳淋巴示踪剂应用于腹腔镜早期胃癌根治手术中有利于定位病灶,缩短手术时间,指导术中淋巴结的清扫和手术切除范围。
Objective To investigate the clinical application of nano-carbon lymphatic tracer in radical laparoscopic radical gastrectomy. Methods Forty-four patients with early distal gastric cancer were randomly divided into two groups: 20 in the experimental group, guided by laparoscopic-assisted D2 distal gastric cancer with nano-carbon lymphatic tracer; 24 in the control group received routine laparoscopic assisted D2 Endoscopic radical gastrectomy. The number of lymph nodes, lymph node metastasis, operation time, intraoperative blood loss and the distance between the lesion and the upper margin were compared between the two groups. Results The number of lymphadenectas in each experimental group was more than that in the control group [(25.0 ± 4.7) vs. (17.0 ± 4.1)] (P <0.05). There was no significant difference in the rate of lymph node metastasis between experimental group and control group (1.2% vs.1.0%) (P> 0.05). Compared with the control group, the patients in the test group had shorter operative time (188 ± 24) min vs. 216 ± 25 min and less blood loss during operation (118 ± 30 vs. 148 ± 33, The distance between the lesion and the upper margin was (3.8 ± 0.9) cm vs. (3.2 ± 1.2) cm (P <0.05). Conclusion Nanocarbon lymphatic tracer applied in laparoscopic radical gastrectomy for early gastric cancer is helpful to locate the lesion, shorten the operation time and direct the range of lymph node dissection and surgical resection.