摘要
目的探讨淋巴结分拣是否有助于提高纳米炭导航3D腹腔镜胃癌根治术后淋巴结分拣数目。方法入选患者随机化分为淋巴结未分拣组与分拣组,进一步根据病理分期及胃癌根治术式实施亚组分析,比较组间淋巴结清扫数目,同时比较围手术期安全性与随访存活率。结果共纳入147例患者,其中淋巴结未分拣组58例、淋巴结分拣组89例,两组患者的基线特征一致。所有患者的平均手术时间(214.8±55.6)min,术中出血量(128.7±106.0)ml,术后并发症12例次(7.5%),围手术期二次手术率1.3%,术后住院时间(11.5±3.7)d,平均随访时间(15.1±6.9)个月,两组均无死亡。两组患者的围手术期安全性差异无统计学意义。淋巴结分拣能够显著提高Ⅰ期胃癌的淋巴结清扫数目[(29.0±12.3)枚比(24.1±7.8)枚,P=0.04],也能够显著提高根治性全胃切除术中的淋巴结清扫数目[(31.3±11.2)枚比(25.1±7.6)枚,P=0.02]。结论淋巴结分拣有助于提高纳米炭导航3D腹腔镜下Ⅰ期胃癌与根治性全胃切除术的淋巴结清扫数目。
Objective To evaluate the effect of lymph node examination on the number of retrieved lymph nodes in carbon nanoparticles-guided 3D laparoscopic radical gastrectomy.Methods Qualified participants were randomized into non-examined or examined group.Sub-group analysis according to different pathological stage or type of radical gastrectomy were conducted.The number of retrieved lymph nodes were compared between groups.Perioperative safety and survival during follow-up period were compared as well.Results A total of 147 patients including 58 cases in non-examined group and the other 89 cases in examined group were collected.Baseline was similar between groups.The overall duration of operation was(214.8±55.6)min,intraoperative bleeding was(128.7±106.0)ml,postoperative complication rate was 7.5%,secondary operation rate was 1.3%,postoperative hospitalization was(11.5±3.7)d,and all were survival during(15.1±6.9)month follow-up period.The safety was similar between two groups.Lymph node examination can significantly improve the number of retrieved lymph nodes for stageⅠgastric cancer(29.0±12.3)vs.(24.1±7.8),P=0.04)and total radical gastrectomy(31.3±11.2)vs.(25.1±7.6),P=0.02).Conclusions Lymph node examination can improved the number of retrieved lymph nodes in stage I gastric cancer and total radical gastrectomy in carbon nanoparticles-guided 3D laparoscopic radical gastrectomy.
作者
陆晓峰
刘颂
艾世超
王行舟
夏雪峰
沈晓菲
宋鹏
康星
王萌
管文贤
Lu Xiaofeng;Liu Song;Ai Shichao;Wang Xingzhou;Xia Xuefeng;Shen Xiaofei;Song Peng;Kang Xing;Wang Meng;Guan Wenxian(Department of Gastrointestinal Surgery,Nanjing Drum Tower Hospital,the Clinical College of Nanjing Medical University,Nanjing 210008,China;Department of Gastrointestinal Surgery,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)
出处
《中华腔镜外科杂志（电子版）》
2020年第6期352-356,共5页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
基金
国家自然科学基金(81602103,81970500)
南京市医学科技发展杰出青年基金(JQX17005,JQX19001)
吴阶平医学基金会卓越外科培育计划(320.2710.1817)。
关键词
纳米炭
腹腔镜胃癌根治术
淋巴结分拣
Carbon nanoparticles
Laparoscopic gastrectomy
Lymph node examination
作者简介
通信作者:管文贤,Email:guan_wenxian@sina.com。
