吲哚菁绿荧光显像技术在腹腔镜直肠癌前切除手术中的应用价值  

Indocyanine green fluorescence imaging during laparoscopic anterior resection in rectal cancer patients

作　　者：曹键[1] 鲍予頔 姜可伟[1] 杨晓东[1] 尹慕军[1] 梁斌[1] 谢启伟[1] 王杉[1] 申占龙[1] 叶颖江[1] Cao Jian;Bao Yudi;Jiang Kewei;Yang Xiaodong;Yin Mujun;Liang Bin;Xie Qiwei;Wang Shan;Shen Zhanlong;Ye Yingjiang(Department of Gastrointestinal Surgery,Peking University People’s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院胃肠外科,100044

出　　处：《中华普通外科杂志》2020年第10期764-767,共4页Chinese Journal of General Surgery

基　　金：国家自然科学基金(51971062)。

摘　　要：目的探讨吲哚菁绿(ICG)荧光显像技术在腹腔镜直肠癌前切除手术中的应用价值。方法回顾性分析2018年10月至2019年3月北京大学人民医院胃肠外科7例应用ICG评估吻合口血供的直肠癌患者的临床资料,分析患者的临床病理特征、手术和术后恢复情况以及并发症等。结果本组7例患者中位手术时间为185 min,中位手术出血量为50 ml,注射ICG到吻合口肠管显像的中位时间为45 s。1例患者因1CG荧光显像提示肠管血运欠佳而行近端肠管扩大切除。中位淋巴结检出数目为16枚。术后中位进流食时间和住院时间分别为4、8 d。所有患者均未出现吻合口漏、腹腔出血、腹腔感染、肠梗阻等严重并发症,无ICG相关不良事件。结论ICG荧光显像判断肠管血供是安全可行的,该技术的应用有望降低直肠癌切除术后吻合口漏的发生率。Objective To investigate the role of indocyanine green(ICG)fluorescence imaging in laparoscopic anterior resection for rectal cancer.Methods A retrospective analysis was performed on 7 patients who had undergone laparoscopic anterior resection with the use of ICG fluorescence imaging at Peking University People’s Hospital between Oct 2018 and Mar 2019.The clinicopathological variables,surgical factors,short-term outcome and complications were analyzed.Results The median operation time was 185 min.The median estimated blood loss was 50 ml.The median time from ICG injection to anastomotic perfusion was 45 s.One patient received extended proximal resection of bowel due to poor perfusion as suggested by ICG imaging.The median time to soft diet was 4 days,and the median hospital stay was 8 days.The median number of lymph nodes harvested was 16.There were no major complications in all these patients.No adverse events related to ICG were recorded.Conclusions ICG fluorescence imaging was safe and effective in detecting insufficient blood supply around newly established bowel anastomsis,hence potentially reducing the anastomotic leakage rate.

关 键 词：直肠肿瘤 吲哚花青绿 吻合口瘘 荧光显像 肠管血供 

分 类 号：R735.37[医药卫生—肿瘤]