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目的探讨纳米碳示踪技术在结肠癌根治术淋巴结清扫中的应用价值。方法选择中国人民解放军第四〇一医院普外科2014年12月至2016年5月收治的54例结肠癌病人为研究对象,采用信封法随机分为试验组(27例)和对照组(27例),试验组于术中在病灶周围取4~6个点浆膜下注射纳米碳注射液共1.0 m L,术中参考黑染的淋巴结适当调整淋巴结清扫范围,比较两组病人淋巴结清扫情况及术后疗效。结果试验组和对照组病人手术时间、出血量、肛门排气时间、住院时间比较差异均无统计学意义(P>0.05)。两组病人淋巴结清扫数分别为(14.4±2.8)枚和(12.8±1.4)枚、阳性淋巴结数分别为(6.0±2.5)枚和(3.6±1.6)枚、直径<5 mm的淋巴结数分别为(6.8±1.6)枚和(3.4±1.4)枚、直径<5 mm的阳性淋巴结数分别为(3.7±1.9)枚和(1.7±1.1)枚,差异均有统计学意义(P<0.05)。结论在结肠癌根治术中采用纳米碳示踪技术可增加结肠癌根治术淋巴结清扫数,提高病理TNM分期(p TNM分期)的准确性。
Objective To investigate the value of nanometer carbon tracing technique in lymph node dissection of colon cancer. Methods 54 cases of colon cancer patients admitted from December 2014 to May 2016 in General Surgery of the 401 Hospital of Chinese People’s Liberation Army were enrolled in the study. They were randomly divided into experimental group (27 cases) and control group (27 cases ). The experimental group received 4-6 sub-serous injection of carbon nanocapsule 1.0 ml around the lesion during the operation. The range of lymph node dissection was adjusted appropriately with reference to the black-stained lymph nodes and the lymph node dissection was compared between the two groups Postoperative effect. Results There was no significant difference between the experimental group and the control group in the operation time, bleeding volume, anal exhaust time and hospitalization time (P> 0.05). The numbers of lymph node dissection in the two groups were (14.4 ± 2.8) and (12.8 ± 1.4), respectively, and the number of positive lymph nodes was (6.0 ± 2.5) and (3.6 ± 1.6) respectively. The number of lymph nodes with diameter <5 mm (6.8 ± 1.6) and (3.4 ± 1.4). The number of positive lymph nodes with diameter <5 mm were (3.7 ± 1.9) and (1.7 ± 1.1), respectively, with statistical significance (P <0.05). Conclusion Nanocarbon tracing technique in radical resection of colon cancer can increase the number of lymph node dissection in radical resection of colon cancer and improve the accuracy of pathological TNM staging (p TNM staging).