Current status and progress in the standardized surgical management of specimens after radical gastric cancer surgery / 中华胃肠外科杂志

Standardized surgical management of postoperative specimens of gastric cancer is an important part of the standardized diagnosis and treatment of gastric cancer. It can reflect the accurate number and detailed distribution of lymph nodes in the specimen and lay the foundation for accurate and standardized pathological reports after surgery. Meanwhile, it can evaluate the scope of intraoperative lymph node dissection, the safety of cutting edge, and the standardization of surgery (principle of en-bloc dissection), which is an important means of surgical quality control. It also provides accurate research samples for further research and is an important way for young surgeons to train their clinical skills. The surgical management of postoperative specimens for gastric cancer needs to be standardized, including specimen processing personnel, processing flow, resection margin examination, lymph node sorting, measurement after specimen dissection, storage of biological specimens, documentation of recorded data, etc. The promotion of standardized surgical management of specimens after radical gastrectomy can promote the homogenization of gastric cancer surgical diagnosis and treatment in medical institutions and further promote the high-quality development of gastric cancer surgery in China.

Current status of research on standardized management of specimens after radical gastrectomy for gastric cancer / 中华胃肠外科杂志

The quality control and standardization of procedures in radical gastrectomy for gastric cancer, especially the standardized processing of specimens after radical gastrectomy for gastric cancer, is very important. It is not only the basis of accurate pathological staging, but also the evidence of surgical quality and the original data of clinical research, which plays a pivotal role. The examination and classification of lymph nodes, specimens processing records, and data uploading and archiving after radical gastrectomy for gastric cancer are indispensable. It is necessary for surgeons to participate in the processing of surgical specimens. This article will combine the current research status and progress at home and abroad to review the standardized processing of specimens after radical gastrectomy for gastric cancer.

Application of carbon nanoparticles labeled lymph node staining combined with artery approach in radical resection of sigmoid colon cancer / 中华消化外科杂志

Objective To explore the clinical application value of carbon nanoparticles labeled lymph node staining combined with artery approach in radical resection of sigmoid colon cancer.Methods The retrospective cohort study was conducted.The clinicopathological data of 40 patients with sigmoid colon cancer who were admitted to the Tumor Hospital of Zhengzhou University (Henan Cancer Hospital) from December 2015 to June 2016 were collected.Among 40 patients undergoing radical resection of sigmoid colon cancer,20 using nanometer carbon lymph node staining combined with artery approach and 20 using the traditional lymph node sorting were respectively allocated into the observation group and control group.Observation indicators:(1) detection of the lymph node and pathological examination;(2) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect adjuvant chemotherapy,tumor recurrence or metastasis and surgery-related complications up to June,2017.Measurement data with normal distribution were represented as (x)±s,and comparisons between groups were evaluated with the t test.Comparisons of count data were analyzed using the chi-square test.The comparisons of ordinal data were analyzed using the nonparametric test.Results (1) Detection of the lymph node and pathological examination:40 patients underwent successful radical resection of sigmoid colon cancer.The lymph node sorting time,total and average numbers of lymph node sorting,total and average numbers of lymph node with diameter ＜ 5 mm,cases with lymph node number ＜ 12 and numbers of the first,second and third stations lymph nodes were respectively (13.1±2.4) minutes,522,28.0±7.0,152,8.6±2.5,0,13.7±3.6,9.5±2.5,4.7±1.2 in the observation group and (18.4±3.5) minutes,239,13.0±3.0,64,3.9± 1.7,6,6.1 ± 1.6,6.6± 2.2,2.5± 1.0 in the control group,with statistically significant differences between groups (t =14.562,24.872,19.256,x2 =4.902,t =14.368,10.026,8.210,P＜0.05).The total number of positive lymph node,positive rate of lymph node,metastasis rate of patients,total and average numbers of positive lymph node with diameter ＜ 5 mm and numbers of the first,second and third stations positive lymph nodes were respectively 82,0.22％±0.13％,17/20,51,3.9± 1.9,4.2± 1.8,1.9±0.6,2.3± 1.2 in the observation group and 43,0.48％±0.18％,7/20,38,2.7±1.5,2.1±0.6,2.6±0.7,1.4±0.5 in the control group,showing no statistically significant difference in the positive rate of lymph node and number of the third station positive lymph nodes between groups (t =1.462,1.759,P＞0.05).There were statistically significant differences in the metastasis rate of patients,average number of positive lymph nodes with diameter ＜ 5 mm and numbers of the first and second stations positive lymph nodes between groups (x2 =10.417,t =7.264,4.682,3.410,P＜0.05).(2) Follow-up situations:40 patients were followed up for 12-18 months,with a median time of 16 months.Eighteen and 10 patients in the observation group and control group received postoperative adjuvant chemotherapy,showing a statistically significant difference between groups (x2=5.833,P＜ 0.05).Tumor recurrence or metastasis was respectively detected in 0 and 2 patients (1 with local recurrence and 1 with liver metastasis) in the observation group and control group,with no statistically significant difference between groups (x2=2.105,P＞ 0.05).During the follow-up,there was no surgery-related complication.Conclusion The carbon nanoparticles labeled lymph node staining combined with artery approach in radical resection of sigmoid colon cancer can increase the sorting rate and number of lymph node,and improve the accuracy of postoperative pathological staging.