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Objective: To investigate the tracing fect of new nano-carbon (Kanalin) on the pelvic lymph nodes of the patents with bladder cancer during the laparoscopic radcal cystectomy (RC), and to explain the signcance of its applicaton in the precision surgical treatment. Methods: A total of 44 patents with bladder cancer who underwent RC were divded into tracer group (n=22) and control group (n=22) according to whether Kanalin was used before operaton or not. The laparoscopic RC combined with standard pelvc lymph node dissecon (LND) was performed in the patents in two groups. The effectiveness evaluaton indexes and safety evaluaton indexes of the patents in two groups were collected and compared. The efectiveness evaluaton indexes included black staining situaton of lymph nodes during operaon, the number of detected lymph nodes, the black staining rate of lymph nodes, the number of positive lymph nodes, and operaton time. The safety evaluaton indexes included the blood loss and the indences of perioperative complicatons. Results: The black sainng fect of lymph nodes of the patents in tracer group was definite and there were no tracer-related sde effects and complicatons during the perioperative period. Compared with control group, the clearance rate and detecon rate of lymph nodes of the patents in tracer group were increased (P 0. 05). Conclusion: During the laparoscopic RC, the applicaton of Kanalin for pelvic lymph node tracng is safe, without toxic and side effects; Kanalin is helpful for ncreasing the intraoperative clearance rates and postoperative pathological detecon rates of lymph nodes.
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Objective To explore the application value of nano carbon lymph tracing technique in the radical resection of gallbladder cancer.Methods The prospective study was conducted.The clinical data of 120 patients with gallbladder cancer who were admitted to the Henan Provincial People's Hospital between January 2010 and December 2014 were collected.All the patients were allocated into the experimental group and control group by random number table.For the experimental group,a total of 0.1 mL carbon nanoparticles were injected at 4-6 locations subserously around the cancerous site,radical resection of gallbladder cancer were performed at 15 minutes after injection,and intraoperative stained lymph nodes were used as markers to guide lymphadenectomy.Patients in the control group underwent regular radical resection of gallbladder cancer.Observation indicators:(1) intra-and post-operative situations;(2) number of lymph node sorting;(3) follow-up situations.Follow-up using telephone interview was performed to detect survival of patients up to January 2016.Measurement data with normal distribution were represented as x-±s and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M(P25,P75),and comparison between groups was analyzed by the Mann-whitney rank-sum test.Comparisons of count data were analyzed using the chi-square test.Comparison of ordinal data were analyzed by the nonparametric test.The survival curve was drawn by the Kaplan-Meier method.Survival analysis was done using the Log-rank test.Results One hundred and twenty patients were screened for eligibility,and were allocated into the experimental group and control group,60 in each group.(1) Intra-and postoperative situations:operation time,volume of intraoperative blood loss and duration of postoperative hospital stay were respectively (164± 51) minutes,(200 ± 98) mL,(13 ± 4) days in the experimental group and (178± 52) minutes,(225±98)mL,(14±5)days in the control group,with no statistically significant difference between groups (t=-l.50,-1.42,-1.03,P＞0.05).(2) Comparison of lymph node sorting:overall number of lymph node sorting,overall number of positive lymph node sorting,number of N2 station lymph node sorting and number of positive N2 station lymph node sorting were respectively 13.0 (12.0,15.0),8.0 (5.0,9.0),7.0 (5.0,8.0),3.0 (2.0,4.0) in the experimental group and 10.0 (8.0,12.0),5.0 (4.0,6.0),5.0 (3.0,5.0),1.0 (1.0,2.0) in the control group,with statistically significant differences between groups (Z =-5.51,-4.37,-6.24,-6.18,P＜0.05).Number of N1 station lymph node sorting and number of positive N1 station lymph node sorting were respectively 6.0 (5.0,6.0),4.0 (3.0,5.0) in the experimental group and 6.0 (4.0,7.0),4.0 (2,0,5.0) in the control group,with no statistically significant difference between groups (Z =-0.82,-1.34,P＞0.05).Overall number of lymph node sorting,overall number of positive lymph node sorting,number of N2 station lymph node sorting and number of positive N2 station lymph node sorting were respectively 5.0 (4.8,6.3),0(0,0.8),2.0 (1.0,3.3),0(0,0.5) in patients with stage Ⅱ of the experimental group and 3.0 (2.0,4.3),0 (0,0),0 (0,1.3),0(0,0) in patients with stage Ⅱ of the control group,with statistically significant differences between groups (Z=-2.96,-2.02,-2.38,-2.01,P＜0.05).Number of N 1 station lymph node sorting and number of positive N1 station lymph node sorting were respectively 3.0 (3.0,3.3),0 (0,0.3) in patients with stage [[of the experimental group and 3.0 (2.0,3.0),0 (0,0) in patients with stage Ⅱ of the control group,with no statistically significant difference between groups (Z=-1.18,-1.81,P＞0.05).Overall number of lymph node sorting,overall number of positive lymph node sorting,number of N2 station lymph node sorting and number of positive N2 station lymph node sorting were respectively 13.0 (12.0,15.0),7.0 (5.0,8.0),7.0 (5.0,8.0),3.0 (2.0,4.0) in patients with stage Ⅲ of the experimental group and 10.0 (9.0,12.0),5.0 (4.0,6.0),5.0 (4.0,5.0),2.0 (1.0,2.0) in patients with stage Ⅲ of the control group,with statistically significant differences between groups (Z =-4.80,-3.43,-5.25,-4.76,P＜ 0.05).Number of N1 station lymph node sorting and number of positive N1 station lymph node sorting were respectively 6.0 (6.0,8.0),4.0 (3.0,5.0) in patients with stage Ⅲ of the experimental group and 6.0 (5.0,7.0),4.0 (3.0,4.5) in patients with stage Ⅲ of the control group,with no statistically significant difference between groups (Z=-1.52,-1.16,P＞0.05).Overall number of lymph node sorting,overall number of positive lymph node sorting,number of N2 station lymph node sorting and number of positive N2 station lymph node sorting were respectively 14.0 (13.0,15.0),9.0 (8.0,10.0),8.0 (7.5,8.0),4.0 (4.0,5.0) in patients with stage Ⅳa of the experimental group and 11.0 (10.0,13.0),6.0 (4.0,8.0),5.0 (5.0,6.0),2.0 (1.0,2.0) in patients with stage Ⅳ a of the control group,with statistically significant differences between groups (Z =-3.47,-3.25,-4.02,-3.92,P＜0.05).Number of N1 station lymph node sorting and number of positive N1 station lymph node sorting were respectively 6.0 (5.5,6.0),5.0 (4.0,5.0) in patients with stage Ⅳa of the experimental group and 6.0 (5.0,7.0),4.0 (3.0,6.0) in patients with stage Ⅳa of the control group,with no statistically significant difference between groups (Z=-0.14,-0.45,P＞0.05).(3) Follow-up situations:120 patients were followed up for 12-60 months,with a median time of 28 months.The postoperative overall survival time was (45.7 ± 2.3) months in the experimental group and (36.5 ± 2.4) months in the control group,with a statistically significant difference between groups (x2 =8.32,P＜ 0.05).The postoperative overall survival time was (54.5±3.0) months in patients with stage Ⅱ of the experimental group and (39.6±0.9)months in patients with stage Ⅱ of the control group,with no statistically significant difference between groups (x2 =3.77,P＞0.05).The postoperative overall survival time was (42.2±2.7)months in patients with stage Ⅲ of the experimental group and (35.0±3.0)months in patients with stage]Ⅲ of the control group,with a statistically significant difference between groups (x2=4.12,P＜0.05).The postoperative overall survival time was (37.7±2.5)months in patients with stage Ⅳa of the experimental group and (27.0±3.1)months in patients with stage Ⅳa of the control group,with a statistically significant difference between groups (x2 =4.14,P＜0.05).Conclusion The nano carbon lymph tracing technique in the radical resection of gallbladder cancer can guide precise operation,increase the numbers of overall and positive lymph nodes sorting,and extend postoperative overall survival time.
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Objective To investigate the clinical significance of the carbon nanoparticles (CN) in prophylactic central compartment lymph node dissection (PCCND) in treatment of clinically node-negative (cN0) papillary thyroid carcinoma.Methods A total of 102 cN0 patients in our department from Dec.2016 to Jun.2017 were enrolled in our study and randomly allocated to the control group (n=51) and the CN group (n=51).All the patients have received (near) total unilateral lobectomy or bilateral thyroidectomy plus the affected side PCCND.The baseline characteristics,lymph node-related indices (including number of total dissected lymph nodes and metastatic lymph nodes at central area) and postoperative complication indices were collected and compared between the 2 groups.Results The differences of baseline characteristics between CN group and the control group were not significant (all P＞0.05).The total number of dissected lymph nodes was 573 in CN group and 334 in the control group.The average lymph nodes in each patient was 11.2±5.46 in CN group,which was higher than 6.5±4.3 of the control group (P＜0.001).The average count of positive lymph nodes was higher in CN group than in the control group (2.0±3.3 vs 0.8±1.5) (P＜0.05).Transient hypocalcaemia happened to 2 patients in CN group and 9 patients in the control group (P=0.025).Conclusions CN can increase the number of lymph nodes in central neck dissection and the rate of metastatic lymph nodes resection.It can decrease the risk of transient parathyroid injury.CN is clinically valuable in treatment of cN0 papillary thyroid cancer undergoing PCCND.
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Objective To study carbon nanoparticles lymphatic tracer to guide surgery for gallbladder cancer.Methods 120 patients with gallbladder cancer were randomized into two groups:the experimental group (n =60) and the control group (n =60).For the experimental group,0.1 ml carbon nanoparticles was injected at 4 ～ 6 locations subserosally around the cancerous site intraoperatively.Stained lymph nodes were used as markers to guide lymphadenectomy.The resected specimens were carefully dissected,and then the lymph nodes were studied according to their positions by histopathological examinations.Results Various degrees of stained lymph nodes were seen in the specimens.In the experimental group,the number of lymph nodes (12.0 ± 3.8),and metastatic lymph nodes (6.3 ± 3.3) per patient were obviously higher than those in the control group (9.2 ± 3.6、4.4 ± 2.8),respectively,(P ＜ 0.05).There were significant differences (P ＜ 0.05) in postoperative disease-free survival and overall survival.Conclusions Intraoperative injection of carbon nanoparticles enhanced lymph node clearance and increased the number of lymph nodes and metastatic lymph nodes dissected,which helped to guide pathological staging.There were significant improvements in disease-free survival and overall survival of these patients with gallbladder cancer after surgery.
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Application of lymphatic tracer has greatly facilitated lymphadenectomy of tumor resection.As a novel lymphatic tracer,activated carbon nanoparticles suspension has high lymph taxis and can stain lymph nodes black as indicators.Thus,carbon nanoparticles can help to track tumor lymphadenectomy,modify the efficiency of lymphadenectomy and improve the prognosis of patients.Now it has been widely applied in the area of surgical treatment of tumors,such as gallbladder cancer,pancreatic cancer,liver cancer,etc.
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Objective To evaluate the clinical value of carbon nanoparticles suspension in gallbladder carcinoma lymphadenectomy.Methods 21 cases of gallbladder carcinoma who received radical resection from January 2008 to August 2013 were randomly divided into experimental group (11 cases received carbon nanoparticles injection into the subserosa around the tumor before operation) and control group (10 cases did not receive any tracer).The number of dissected lymph nodes,black-stained lymph nodes and positive lymph nodes were analyzed.Results A total of 138 lymph nodes were resected in experiment group,average 12.546±5.047 lymph nodes per patient,which was significantly more than that in control group in which there were overall 87 lymph nodes,average 8.700±2.497 lymph nodes per patient (t =2.176,P =0.042).The blacken rate of lymph nodes in experimental group was 56.522 ％ (78/138).There were 46 metastasis lymph nodes out of 79 blacken lymph nodes,and the positive rate was significantly higher than that of non-blacken lymph nodes [58.228 ％ (46/79) vs 38.983 ％ (23/59),P=0.039].There was no local or systemic adverse reaction occurred in experimental group.Conclusions Carbon nanoparticles suspension maybe helpful for lymphadenectomy during radical gallbladder carcinoma dissection to reduce operating damage and be safe.
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Objective:To define the role of lymph tracers in lymph node dissection and pathological examination of papillary thyroid carcinoma. Methods:Patients with papillary thyroid carcinoma who met inclusion criteria were enrolled and randomly assigned into the three groups, namely, carbon nanoparticle (CN), methylene blue (MB), and conventional surgery (CS) groups. The number of detected lymph nodes in each group was summed, and pathological examination was conducted. Histological examination of the lymph node specimens in the tracer group was performed based on the classification of staining and nonstaining groups. Results:Major complications such as anaphylaxis did not occur after injection of CN and MB. The average of the detected lymph nodes was higher in the tracer group than in the CS group, and the detection rate of the lymph node was higher in the CN group than in the MB group. In addition, the rate of cancer metastasis was higher in the group with stained lymph node than in the group with unstained lymph node. The index of the CN group was higher than that of the MB group. Conclusion:The tracing effect and lymphatic tropism of CNs were stronger than MB. The thyroid lymph tracer technique may promote the normalization and thoroughness of lymph node dissection in thyroid cancer.