腹腔镜胃癌根治术无瘤技术的应用研究

摘要

Objective:To explore the application of laparoscopic gastric cancer after radical disease-free technol-ogy,evaluate the safety and feasibility. Methods:Collect 65 patients with gastric cancer underwent laparoscopic surgi-cal resection in before and after abdominal rinses,cytological examination intraperitoneal free cancer cells,fluid cytol-ogy(FCM)method in detecting celiac rinses carcinoembryonic antigen(CEA)and matrix metalloproteinases -7 (MMP-7),compare the preoperative and postoperative detection rate. Results:In 65 cases of specification disease-free laparoscopic operation intraperitoneal free cancer cells in patients with preoperative and postoperative gastric cancer radical detection rate was 6. 15%(4/65)and 9. 23%(6/65),CEA detection rate of preoperative and postop-erative were 46. 2%(30/65)and 52. 3%(34/65),MMP-7 detection rate of preoperative and postoperative were 56. 9%(37/65)and 64. 6%(42/65),higher than before the operation,but there was no statistically significant difference between the two(P ﹥0. 05). Conclusion:Strictly operation rules on disease -free,laparoscopic gastric cancer radical shedding not increase cancer cells,nor increase abdominal planting transfer probability,is safe and fea-sible.%目的：探讨应用无瘤技术后腹腔镜下胃癌根治术对肿瘤脱落细胞的影响，评价其安全性及可行性。方法：收集65例行腹腔镜胃癌手术患者切除前后腹腔冲洗液，细胞学检测腹腔游离癌细胞，并以流式细胞学（FCM）方法检测腹腔冲洗液癌胚抗原（CEA）及基质金属蛋白酶-7（MMP-7），对比术前、术后检出率。结果：65例规范无瘤操作的腹腔镜胃癌根治术患者腹腔游离癌细胞术前、术后检出率分别为6.15%（4/65）和9.23%（6/65），CEA检测阳性率术前、术后分别为46.2%（30/65）和52.3%（34/65），MMP-7检测阳性率术前、术后分别为56.9%（37/65）和64.6%（42/65），术后较手术前高，但两者差异无统计学意义（ P﹥0.05）。结论：严格遵守无瘤操作规程的腹腔镜胃癌根治术，不增加癌细胞的脱落，也不增加腹腔种植转移几率，是安全可行的。