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目的应用注射亚甲蓝和脂溶技术,提高直肠癌新辅助治疗后手术标本微小淋巴结的检出率,以期获得准确的病理分期。方法选择2006年12月~2013年11月云浮市人民医院普外科收治的25例新辅助治疗后行直肠癌根治术患者的手术标本作为自身对照,先采用常规触摸法,后注射亚甲蓝在同一标本上寻找淋巴结,最后使用脂溶技术,再次取材,对结果进行统计学分析。结果依靠常规方法检出淋巴结127枚,平均每例(5.08±1.92)枚;直肠系膜组织经注射亚甲蓝及溶脂技术后检出淋巴结163枚,平均每例(6.52±2.24)枚,其中5 mm以下的淋巴结136枚。使平均淋巴结检获数增加到(11.60±2.5)枚。5例患者由ypN1升为ypN2。结论该方法能有效地检出直肠癌新辅助治疗后手术标本的微小淋巴结,以获得更准确的病理分期。
Objective To evaluate the detection rate of lymph nodes in neoplasms after neoadjuvant therapy with injection of methylene blue and lipolysis, in order to obtain accurate pathological staging. Methods From December 2006 to November 2013, 25 cases of patients undergoing neoadjuvant resection of colorectal cancer underwent surgical resection in the Department of General Surgery, Yunfu People’s Hospital from December 2006 to November 2013 as their own control. The first use of conventional touch method, followed by injection of methylene blue The same specimen to find lymph nodes, the final use of fat-soluble technology, drawing again, the results were statistically analyzed. RESULTS: A total of 127 lymph nodes (5.08 ± 1.92) were detected by conventional methods. There were 163 lymph nodes (6.52 ± 2.24) in each group after injection of methylene blue and lipolysis. Among them, There are 136 lymph nodes below 5 mm. The average number of lymph node seizures increased to (11.60 ± 2.5) pieces. Five patients rose from ypN1 to ypN2. Conclusion This method can detect tiny lymph nodes of the surgical specimens after neoadjuvant treatment of rectal cancer effectively to obtain a more accurate pathological staging.