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中华普外科手术学杂志(电子版) ›› 2022, Vol. 16 ›› Issue (05) : 537 -540. doi: 10.3877/cma.j.issn.1674-3946.2022.05.019

论著

不同淋巴结示踪方案在腹腔镜保留脾脏的近端胃癌脾门淋巴结清扫中的临床研究
李爱华1,(), 龚云翔1, 闫元1, 刘灿1   
  1. 1. 434200 湖北松滋,湖北省松滋市人民医院普通外科
  • 收稿日期:2021-10-12 出版日期:2022-10-26
  • 通信作者: 李爱华

Clinical study of different lymph node tracing protocols in laparoscopic splenic hilar lymph node dissection of proximal gastric cancer with splenic preservation

Aihua Li1,(), Yunxiang Gong1, Yuan Yan1, Can Liu1   

  1. 1. Department of General Surgery, Songzi City People’s Hospital, Songzi Hubei Province 434200, China
  • Received:2021-10-12 Published:2022-10-26
  • Corresponding author: Aihua Li
  • Supported by:
    Hubei Provincial Health Commission 2019 Annual General Project(WJ2019M052)
引用本文:

李爱华, 龚云翔, 闫元, 刘灿. 不同淋巴结示踪方案在腹腔镜保留脾脏的近端胃癌脾门淋巴结清扫中的临床研究[J/OL]. 中华普外科手术学杂志(电子版), 2022, 16(05): 537-540.

Aihua Li, Yunxiang Gong, Yuan Yan, Can Liu. Clinical study of different lymph node tracing protocols in laparoscopic splenic hilar lymph node dissection of proximal gastric cancer with splenic preservation[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(05): 537-540.

目的

研究不同淋巴结示踪方案在腹腔镜保留脾脏的近端胃癌脾门淋巴结清扫中的应用效果。

方法

回顾性分析2016年6月至2020年12月133例行腹腔镜近端胃癌根治术患者临床资料。根据术中使用不同淋巴结示踪方案将患者分为纳米碳组(n=91例)和ICG组(n=42例)。临床数据分析采用统计学软件SPSS 24.0。围手术期指标、淋巴结清扫情况等计量资料以(

xˉ
±s)表示,组间比较采用独立样本t检验。术后并发症发生率等计数资料采用χ2检验。当P<0.05时视为组间差异有统计学意义。

结果

ICG组手术时间、脾门淋巴结清扫时间短于纳米碳组(P<0.05),两组患者术中出血量、术后排气时间及术后住院时间比较差异均无统计学意义(P>0.05)。纳米碳组及ICG组患者术后并发症发生率分别为12.1%及14.3%,组间差异无统计学意义(P>0.05)。两组淋巴结示踪效果、清扫数目、淋巴结检出阳性率、脾门淋巴结清扫数目、脾门淋巴结阳性率比较差异无统计学意义(P>0.05)。随访截止至2021年7月,中位随访时间31个月,两组患者术后3年累积生存率比较差异无统计学意义(63.7% vs. 58.8%,P>0.05)。

结论

纳米碳及ICG两种示踪方案在腹腔镜保留脾脏的近端胃癌脾门淋巴结清扫中均有良好的应用价值,ICG的视觉效果更突出,可缩短手术时间和脾门淋巴结清扫时间,且价格低廉,具有一定的优势。

Objective

To investigate the application effect of different lymph node tracing schemes in laparoscopic splenic hilar lymph node dissection of proximal gastric cancer with splenic preservation.

Methods

The clinical data of 133 patients who underwent laparoscopic proximal radical gastrectomy for gastric cancer from June 2016 to December 2020 were retrospectively analyzed. The patients were divided into carbon nanoscale group(n=91)and ICG group(n=42)according to different lymph node tracing schemes used during operation. Statistical software SPSS 24.0 was used for clinical data analysis. Measurement data such as perioperative indicators and lymph node dissection were expressed as(

xˉ
±s). Independent sample t test was used for comparison between groups. The incidence of postoperative complications and other enumerative data were analyzed by using the χ2 test. When P<0.05,the difference between groups was considered statistically significant.

Results

The operation time and splenic hilar lymph node dissection time in ICG group were shorter than those in nano-carbon group(P<0.05). There were no significant differences in intraoperative blood loss,postoperative exhaust time and postoperative hospital stay between the two groups(P>0.05). The incidence of postoperative complications was 12.1% in the carbon nanoscale group and 14.3% in the ICG group,and there was no significant difference between the two groups(P>0.05). There were no significant differences in lymph node tracing effect,number of dissected lymph nodes,positive rate of lymph node detection,number of splenic hilar lymph nodes dissected,and positive rate of splenic hilar lymph nodes between the two groups(P>0.05). The median follow-up time was 31 months until July 2021. There was no significant difference in the 3-year cumulative survival rate between the two groups(63.7% vs. 58.8%,P>0.05).

Conclusion

Both carbon nanoparticles and ICG tracer schemes have good application value in laparoscopic splenic hilar lymph node dissection of proximal gastric cancer with splenic preservation. ICG has more prominent visual effect,can shorten the operation time and splenic hilar lymph node dissection time,and the price is low,which has certain advantages.

表1 133例腹腔镜近端胃癌根治术中不同淋巴结示踪方案两组患者临床基线资料比较[(
xˉ
±s),例]
表2 133例腹腔镜近端胃癌根治术中不同淋巴结示踪方案两组患者围手术期指标比较(
xˉ
±s)
表3 133例腹腔镜近端胃癌根治术中不同淋巴结示踪方案两组患者术后并发症发生率比较[例(%)]
表4 133例腹腔镜近端胃癌根治术患者淋巴结清扫情况比较(
xˉ
±s)
图1 133例腹腔镜近端胃癌根治术患者术后3年累计生存曲线
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