Application value of nano-carbon tracer technique in the treatment of malignant tumors of pancreatic body and tail in radical antegrade modular pancreatosplenectomy

Abstract

Objective The application of nano-carbon tracer technique in radical antegrade modular pancreatosplenectomy (RAMPS) to treat malignant tumors of pancreatic body and tail. To investigate whether radical anterograde modulization of pancreatic body and tail combined with nano-carbon tracer technique is more beneficial to the prognosis of patients. Methods From January 2014 to September 2018, a retrospective analysis was performed in 48 patients in Linyi Central Hospital, all patients underwent RAMPS, all of whom were pathologically proved to be pancreatic carcinoma of the body and tail.Based on whether the nano-carbon lymph node tracer was performed during the operation, the patients were divided into two groups: nano-carbon group (nano-carbon lymph node tracing) and conventional operation group (no nano-carbon lymph node tracer). The differences between the two groups were analyzed, including operative time, intraoperative blood loss, postoperative complications (pancreatic fistula), postoperative hospitalization time, postoperative pathological lymph node status (number of dissection, number of positive lymph nodes, the positive rate of lymph node black staining in nano-carbon group) and survival time after operation .The measurement data were expressed as mean±standard deviation (Mean±SD), t-test were used for comparison among groups; Chi-square test was used for comparison of counting data, and Kaplan-Meier test was used for comparison of survival rate. Results There was no significant difference in the time of operation [(4.45±0.59) h vs (4.41±0.65) h], the amount of blood lost during operation [(447.39±109.51) ml vs (434.8±76.38) ml] and the time of hospitalization after operation [(16.52±4.12) d vs (16.56±2.92) d] between the two groups (P>0.05). There were 1 case of pancreatic fistula in the nano-carbon group and 2 cases of pancreatic fistula in the convertional operation group, but the difference was not statistically significant (P=0.55). The number of lymph nodes dissected and positive lymph nodes in nano-carbon group were significantly higher than those in conventional operation group [(18.26±2.49) vs (12.16±2.19); (5.52±1.50) vs (3.32±0.85). The difference was statistically significant (P<0.05). The positive rate of lymph nodes in black stained lymph nodes (38.10%, 96/252) was significantly higher than that in non-stained lymph nodes (18.45%, 31/168), and the difference was statistically significant (P<0.05). The average survival time in the nano-carbon group [(25.48 ±11.74) months] was significantly longer than that in the conventional operation group [(15.80±11.64) months], and the difference was statistically significant (P<0.05). Conclusions It is safe, effective and feasible to treat malignant tumors of pancreatic body and tail by RAMPS combined with nano-carbon tracer technique. The positive rate of lymph node dissection and the detection rate of total lymph nodes are increased, and the prognosis of patients is improved, to improve the survival time of patients after operation is improved. Key words: Coloring agents; Pancreatic neoplasms; Lymph node excision; Nanoparticles; Lymphatic metastasis