目的 探讨经直肠上动脉灌注亚甲蓝对直肠癌行全直肠系膜切除术(TME)后标本淋巴结获检数的临床意义.方法 将按照TME原则进行直肠癌根治术的40例直肠癌患者的切除标本,按随机数字表法分为对照组和亚甲蓝组,每组20例.术后立即于标本肠系膜上动脉灌注亚甲蓝,获取标本淋巴结数目,并进一步探讨所获检淋巴结的阳性率.结果 常规组经传统触摸法获检淋巴结为(13.9±3.4)枚/例,亚甲蓝组获检淋巴结为(22.5±4.0)枚/例,两组淋巴结获检数差异显著(P＜0.05);亚甲蓝组检出阳性淋巴结获检(2.9±1.8)枚/例,常规组获检(1.3±1.2)枚/例,两组淋巴结获检数差异显著(P＜0.05).结论 经直肠上动脉灌注亚甲蓝是一种简单、安全、经济的方法,能够提高直肠癌患者术后标本淋巴结的获检数目,提供更准确的临床分期.%Objective To evaluate the clinical significance of methylene blue perfusion through the superior rectal artery to the improvement of lymph node harvest in rectal cancer specimen after total mesorectal excision( TME ). Methods Forty patients with rectal carcinoma received the radical resection according to the TME principle. Their excision specimens were randomly divided into control group (n=20)and methylene blue group( n = 20 ). After the operation, methylene blue was injected into the superior mesenteric artery of the specimen immediately. The numbers of the lymph node in the specimens were obtained,and the positive lymph nodes were counted. Results The number of lymph node obtained by the conventional touching method was 13.9 ±3.4 per case in the control group and was 22.5 ±4.0 per case in the methylene blue group( P <0.05 ). The positive lymph node number was 2.9 ±1.8 per case in the methylene blue group and was 1.3 ±1.2 per case in the control group( P < 0. 05 ). Conclusion Methylene blue perfusion via superior rectal artery is a simple, safe, and economical method,which is helpful to increase the detected number of lymph node in the samples.
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