Clinical Trials Study
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World J Clin Cases. Jan 21, 2022; 10(3): 870-881
Published online Jan 21, 2022. doi: 10.12998/wjcc.v10.i3.870
Role of carbon nanotracers in lymph node dissection of advanced gastric cancer and the selection of preoperative labeling time
Kai Zhao, Bao-Qiang Shan, Yan-Peng Gao, Jia-You Xu
Kai Zhao, Bao-Qiang Shan, Yan-Peng Gao, Jia-You Xu, Department of General Surgery, WFPH, Weifang 261400, Shandong Province, China
Author contributions: Zhao K, Shan BQ and Gao YP designed the research study; Zhao K, Shan BQ performed the research; Zhao K, Shan BQ, Gao YP contributed new reagents and analytic tools; Zhao K, Shan BQ and Xu JY analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Weifang People’s Hospital Institutional Review Board (Approval No. 2021-021).
Clinical trial registration statement: This study is registered at chinese clinical trial registry: https://www.chictr.org.cn, registration No. ChiCTR2100050003.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors of this manuscript have directly participated in planning, execution, and analysis of this study. The contents of this manuscript have not been copyrighted or published previously. The contents of this manuscript are not now under consideration for publication elsewhere. There are no directly related manuscripts or abstracts, published or unpublished, by any authors of this manuscript. No financial support or incentive has been provided for this manuscript.
Data sharing statement: This study had already registered at Resman (http://www.medresman.org.cn) and its data is available from http://www.medresman.org.cn/uc/project/projectedit.aspx?proj=8208, also available from the corresponding author: xujiayou5252@sina.com
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jia-You Xu, MD, Chief Doctor, General Surgery, WFPH, No. 152 Guangwen Street, Weifang 261400, Shandong Province, China. xujiayou5252@sina.com
Received: August 18, 2021
Peer-review started: August 18, 2021
First decision: October 3, 2021
Revised: October 19, 2021
Accepted: December 22, 2021
Article in press: December 22, 2021
Published online: January 21, 2022
Processing time: 150 Days and 11.2 Hours
ARTICLE HIGHLIGHTS
Research background

Gastric cancer deaths in China account for more than 40% of the global total of gastric cancer deaths in the same period. Reducing cancer-related mortality and improving quality of life is one of the current research focuses, and the number of lymph nodes dissected was an independent factor affecting postoperative staging of gastric cancer. There are still no specific guidelines for when preoperative labeling should be performed, based on many previous works, this work extended the time of preoperative submucosal tracer injection, and discuss whether it is effective.

Research motivation

In order to help surgeons to more lymph node dissection, and improve postoperative pathological staging; At the same time, whether the preoperative labeling time has a certain influence on the number of lymph node dissection was studied.

Research objectives

To study the influence of preoperative carbon nanoparticle labeling combined with radical gastrectomy on the number of dissected lymph nodes and postoperative anti-tumor treatment effect, and to study the influence of preoperative labeling time on the number of dissected lymph nodes.

Research methods

Retrospective analysis study was performed, all patients were randomly divided into experimental group (preoperative injection of carbon-nano group) and control group (preoperative injection of carbon-nano group) according to the principle of randomization; In the experimental group, according to the different groups of preoperative labeling time, the differences between the groups were studied.

Research results

The average number of dissected lymph nodes in the experimental group [34.95 ± 4.81/case in the laparoscopic total gastrectomy (LTG) group; 32.65 ± 3.82/case in the laparoscopic subtotal gastrectomy (LSG) group] was higher than that in the control group (31.90 ± 4.47/case in the LTG group; 30.88 ± 2.69/case in the LSG group, P < 0.05). In comparisons within the experimental group, the experimental results (number of lymph node dissections, number of black-staining lymph nodes) of the nano-carbon labeling group 2 and 1 d before surgery were better than those of the labeling group on the day before surgery (P < 0.05).

Research conclusions

(1) Nano-carbon labeling has a good guiding effect on lymph node dissection during laparoscopic gastric cancer, and it is safe and effective; and (2) Compared with the control group, submucosal injection of a carbon tracer in the experimental group at a certain time before surgery can significantly improve the lymph node detection rate (P < 0.05), which is conducive to pathological staging and follow-up anti-tumor comprehensive treatment.

Research perspectives

Gastric cancer is the fifth most common cancer in the world, redical operation is still the preferred treatment method for advanced gastric cancer, postoperative lymph node detection rate is one of the major factors affecting PN staging of lymph node metastasis after radical gastrectomy, In order to help the surgeon correctly distinguish the normal tissue from the lymph nodes and dissect lymph nodes as much as possible, endoscopic injection of carbon nanoparticles was selected.