【作者】 林烈文；

【导师】 潘凯；

【作者基本信息】 暨南大学 ， 外科学， 2009， 硕士

【摘要】 目的:应用纳米活性炭注射在胃癌周边组织对淋巴结进行染色、示踪,从而在胃癌根治术中系统地清扫第二站淋巴结,探讨腹腔镜胃癌根治术中清扫淋巴结的方法及其效果。方法:将2008年2月～2009年3月间在我科住院的40例进展期胃癌患者分成两组,一组接受腹腔镜胃癌D2根治术(腹腔镜组),另外一组接受开腹D2胃癌根治术(开腹组),两组患者均于术中在距肿瘤周边约5-8mm处胃壁浆肌层内分六点注射纳米活性炭1ml(50mg),对胃周引流淋巴结进行示踪,比较两组手术中清扫出的淋巴结个数和黑染淋巴结个数、黑染度。结果:两组手术中胃周引流淋巴结能黑染,对淋巴结清扫起指引作用。腹腔镜组的黑染淋巴结个数、黑染度(%)为17.8±5.7、65.6±4.5,开腹组的黑染淋巴结个数、黑染度(%)为17.0±5.0、65.3±4.4,两组比较P＞0.05,无统计学差异;腹腔镜组和开腹组术中清扫出的淋巴结个数分别为27.7±9.1,26.0±7.6。两组比较P＞0.05,差别无显著性意义。结论:在腹腔镜胃癌根治术中,纳米活性炭仍能使胃周引流淋巴结黑染,对淋巴结的清扫起指引作用,其效果与开腹手术相同。腹腔镜胃癌D2根治术治疗进展期胃癌,能达到与开腹手术相同的淋巴结清扫效果。更多还原

【Abstract】 Object:To study the way and effect of lymphonode scavenge in laparoscopic radical gastrectomy,by injecting carbon nanoparticles suspension to dye and trace the lymphonode around stomach tumor.Methods:40 patients with progressive gastric cancer who received operation in our deparment were chosed between Feb 2008 and March 2009.They were randomly divided into two groups.Group one received traditional gastric cancer D2 radical operation(G1).Group 2 adopted laparoscopic radical gastrectomy(G2).Both groups were injected carbon nanoparticles around tumor in 6 points during the opertaion to trace the lymphonode drain.Then we compared the lymphonode numbers scavenged during operation and metastatic lymphonode numbers,metastatic rate.Result:Lymphonodes draining around stomach can be dyed in both operation,which has guide role for lymphonode scavenge.The metastatic lymphonode number and metastatic rate(%) of G1 and G2 was 17.0±5.0、65.34±4.4 and 17.8±5.7、65.6±4.5 (P＞0.05,no significance).The lymphonode number scavenged in operation for G1 and G2 was 26.0±7.6 and 27.7±9.1(P＞0.05,no significance).Conclusions:Carbon nanoparticles suspension injection can dye and trace the lymphonode drain around stomach,which has guide role in laparoscopic radical gastrectomy.Laparoscopic radical gastrectomy has the same lymphonode-scaveneged efficacy as traditional gastric cancer D2 radical operation for progressive gastric cancer,scilicet the same recent radical effect.更多还原