| Objective: Precise localization of the tumor is a prerequisite to ensure complete tumor resection in additional surgery after endoscopic resection of early colon cancer.The purpose of this study was to evaluate the role of combined positioning of carbon nanoparticles and titanium clips in additional laparoscopic surgery.Methods: A retrospective analysis was performed on the clinical data of 34 patients with early colon cancer who underwent endoscopic resection at the General Surgery of the 900 Hospital of the Joint Logistics Team from January 2015 to January 2020.According to the operation of preoperative positioning,they were divided into two groups.The tag group received preoperative endoscopic carbon nanoparticles and titanium clip combined labeled,while the control group was labeled by titanium clips,and intraoperative colonoscopy was performed if necessary.The patients general information(age,gender,BMI),tumor location,carbon nanoparticles labeled clarity,presence or absence of abdominal infection,intraoperative time to detect the tumor,the operation time,the surgical margin,postoperative pathological lymph node metastasis,postoperative pathological tumor distance from proximal resection margins,number of lymph nodes,and postoperative complications of the two groups were compared.Results: The general information(gender,age,BMI)and tumor locatio of the two groups of patients were not statistically significant(P> 0.05).In the tag group,the median time between preoperative carbon nanoparticles and titanium clip combined labeled and surgery was 5 days.34 patients(100%)in the two group could see two titanium clips on abdominal plain films.And sixteen patients(94.1%)successfully found the black carbon nanoparticles stained areas during laparoscopic surgery in the tag group.No symptoms such as fever and abdominal pain associated with the positioned method were found in the patients in the tag group.Both groups of patients underwent R0 resection.There were no statistically significant differences in surgical methods,number of lymph nodes,and lymph node metastasis between the two groups(P > 0.05).The intraoperative time to detect the tumor and operation time in the tag group were significantly lower than those in the control group(2.35 ± 1.52 min vs.5.62 ± 1.86 min,P <0.05;140.24 ± 30.29 min vs.168.35 ± 39.31 min,P <0.05).The final surgical approach of the tag group were consistent with the surgical plan,and no surgical plan was changed or converted to open surgery.Only one patient in the control group who underwent resection of a longer intestinal segment due to nonconformity between preoperative and intraoperative localization.The average distance between the tumor and the proximal resection margin was shorter than the control group,and the difference was statistically significant(P <0.05).A total of 3patients(1 in the labeled group and 2 in the control group)had postoperative complications,with no difference between the two groups(P < 0.05).Conclusions:The positioning method of carbon nanoparticles and titanium clip combined labeled under preoperative endoscopy can precisely locate the original lesions of patients with early colon cancer who undergo additional surgery after endoscopic resection.Accurate preoperative positioning can provide a reliable basis for the choice of Trocar position and surgical incision in laparoscopic surgery,and avoid surgical errors caused by poor visibility of the surgical field due to incorrect selection of Trocar position.The rapid and accurate intraoperative localization of the lesion can shorten the operation time,reduce the amount of bleeding during the operation,ensure sufficient safe resection margins,and provide guidance for the operator to accurately resect the tumor.The positioning method of preoperative endoscopic carbon nanoparticles and titanium clip combined labeled is a safe and effective positioning method. |
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