Clinical Application Of Carbon Nanoparticles (CNP) In Laparoscopic Radical Resection For Rectal Carcinoma

With the development of laparoscopic operation, we have accepted it’s great advantage over traditional laparotomy. Because of the lack of tactile sense in laparoscopic curative resection for rectal carcinoma,it is difficult to recognize and clear the lymph nodes;In the course of the diagnosis of postoperative pathological specimen, occasionally we can’t find more than 12 lymph nodes stipulated by AJCC with the method of observation and touch, especially it is more difficult to find<5mm lymph nodes. We take advantage of CNP, a lymphatic tracer to consider the value of clearing lymph nodes and detection of lymph nodes of pathological specimen.Part 1 the factor of dyeing effects of CNPObjective:The factors of dyeing effects of CNP conclude the work experience of operators、the dyeing time、the injection site、the injection level、 the injected dose、the tumor location the infiltration layers of tumor、the appearance of tumor、the degrees of tumor differentiation the metastasis of tumor and so on. In this part, we will discuss the impact of some changeful factors of all above on the dyeing effects of CNP.Methods:We collected the clinical information of 50 patients in Qilu Hospital from 2014.01 to 2015.02,who received laparoscopic curative resection for rectal carcinoma stained by CNP. Then we will discuss the impact of some changeful factors on the dyeing effects of CNP, which conclude the dyeing time、the injection site、the injection level、the tumor location、the infiltration layers of tumor、the appearance of tumor the degrees of tumor differentiation、the metastasis of tumor. We evaluation the dyeing effects of CNP by the stained region、the whole number of cleared lymph nodes and the number of stained lymph nodes.Results:The dyeing time、the injection site、the injection level、the tumor locationn the infiltration layers of tumor、the appearance of tumor、the degrees of tumor differentiation、the metastasis of tumor have no effect on the stained region、the whole number of cleared lymph nodes and the number of stained lymph nodes.Conclusions:The effect of lymph tracer of CNP was favorable, lymph nodes and the tumor were stained black for a long time. Different tumor has the similar dyeing effects,so CNP can apply to different dyeing time、different site、different differentiation and different appearance of tumor. tumor location、the infiltration layers of tumor、the appearance of tumor the degrees of tumor differentiation、the metastasis of tumor. We evaluation the dyeing effects of CNP by the stained region、the whole number of cleared lymph nodes and the number of stained lymph nodes.Results:The dyeing time、the injection site、the injection level、the tumor locationn the infiltration layers of tumor、the appearance of tumor、the degrees of tumor differentiation、the metastasis of tumor have no effect on the stained region、the whole number of cleared lymph nodes and the number of stained lymph nodes.Conclusions:The effect of lymph tracer of CNP was favorable, lymph nodes and the tumor were stained black for a long time. Different tumor has the similar dyeing effects,so CNP can apply to different dyeing time、different site、different differentiation and different appearance of tumor.Part 2 the advantage of CNP in laparoscopic curative resection for rectal carcinomaObjective:In last part, we confirmed that CNP can apply to different dyeing time、different site、 different differentiation and different appearance of tumor. So in this part, we will discuss the advantage of CNP in laparoscopic curative resection for rectal carcinoma.Methods:We exclude 5 cases of above all 50, in which the intestinal wall were penetrated when injecting CNP, so we arranged the clinical information of the rest of 45 cases. Then we collected the clinical information of other 45 patients received laparoscopic curative resection for rectal carcinoma without CNP at the same time. We will compare the number of detected lymph nodes and metastatic positive rate of lymph nodes.Results:The average of detected lymph nodes in the CNP group was 20.53,while 12.6 in the control group. The average of detected lymph nodes in the CNP group was more than that in the control group(P<0.05)。Metastatic positive rate of lymph nodes in the CNP group was 5.5%, while metastatic positive rate of total lymph nodes in the control group was 3.9%; Metastatic positive rate of lymph nodes in the CNP group was similar to metastatic positive rate of total lymph nodes in the control group(P>0.05); The stained black lymph nodes of the 3 cases were all para-aortic lymph nodes, and all the 6 lymph nodes do not metastasize.Conclusions:The number of detected lymph nodes in the CNP group was more than that in the control group, which will help increase the accuracy of pathology. Stained black lymph nodes can’t preliminarily judge the condition of metastasis, but more large-scale studies need to prove it.