吲哚菁绿荧光标记管状胃制作在胸腹腔镜食管手术中的应用体会  

Application of indocyanine green fluorescent imaging labeling in production of gastric conduits in thoracoscopic and laparoscopic esophagectomy

作　　者：宋宣统 郭金成 SONG Xuan-tong;GUO Jin-cheng(Department of Thoracic Surgery,Jiaozuo Second People’s Hospital,First Affiliated Hospital of Henan Polytechnic University,Jiaozuo 454000,China)

机构地区：[1]焦作市第二人民医院胸外科,河南理工大学第一附属医院,河南焦作454000

出　　处：《腹腔镜外科杂志》2020年第12期915-918,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨胸、腹腔镜食管癌根治颈部吻合术中静脉注射吲哚菁绿后通过观察游离胃的荧光显像制作管状胃对颈部食管胃吻合口漏的影响。方法:回顾分析2017年7月至2019年7月为203例患者行胸、腹腔镜食管癌根治颈部吻合术的临床资料,其中40例经静脉注射吲哚菁绿改良管状胃的制作(实验组),163例行常规管状胃的制作(对照组),比较两组患者一般情况及颈部吻合口漏的发生情况。结果:两组患者年龄、性别、病变位置、病变长度、病理类型、病理分期、手术时间、吻合时间、出血量差异无统计学意义;实验组颈部吻合口漏发生率、住院时间优于对照组,差异有统计学意义(P<0.05)。结论:胸、腹腔镜食管癌根治颈部吻合术中,与常规管状胃相比,改进的管状胃减少了颈部食管胃吻合口漏的发生,是直观、精准的管状胃制作方法,优于常规管状胃的制作。Objective:To investigate the effect of gastric conduit made by fluorescence imaging of the free stomach after intravenous indocyanine green injection on cervical esophagogastric anastomotic leakage in thoracoscopic and laparoscopic cervical anastomosis for radical resection of esophageal cancer.Methods:Clinical data of 203 patients who underwent thoracoscopic and laparoscopic cervical anastomosis for radical resection of esophageal cancer from Jul.2017 to Jul.2019 were reviewed.40 patients among them were given indocyanine green intravenously to improve the making of gastric conduit(experimental group),and 163 patients were routinely made of gastric conduit(control group).The general conditions of the two groups and the occurrence of cervical anastomotic leakage were compared.Results:There were no statistical differences in age,gender,lesion location,lesion length,pathological type,pathological stage,operation time,anastomotic time and bleeding volume between the two groups,but there were statistical differences in the occurrence of cervical anastomotic leakage and hospital stay(P<0.05),experimental group was better than control group.Conclusions:Compared with conventional tubular stomach,the improved gastric conduit reduces the incidence of cervical esophagogastric anastomotic leakage in the thoracoscopic and laparoscopic cervical anastomosis for radical resection of esophageal cancer.This method is an intuitive and accurate method for the making of gastric conduit,and is better than the conventional method.

关 键 词：食管癌 腹腔镜检查 胸腔镜检查 吲哚菁绿荧光显像 管状胃 

分 类 号：R735.1[医药卫生—肿瘤]