吲哚菁绿荧光显像技术在腹腔镜肝切除术中的应用体会  

Application of indocyanine green fluorescence imaging technique in laparoscopic hepatectomy

作　　者：郭成[1] 宋涛[1] 郑鑫[1] 殷国志[1] 孙昊[1] 杨威[1] 刘青光[1] 姚英民[1] GUO Cheng;SONG Tao;ZHENG Xin(Department of Hepatobiliary Surgery,First Affiliated Hospital,School of Medicine,Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院肝胆外科,陕西西安710061

出　　处：《腹腔镜外科杂志》2021年第2期81-85,共5页Journal of Laparoscopic Surgery

基　　金：西安交通大学第一附属医院新医疗新技术(XJYFY-2016w23)。

摘　　要：目的:比较吲哚菁绿荧光显像系统引导下的腹腔镜技术与传统腹腔镜技术在肝肿瘤切除术中发现微小肝内转移病灶的能力及切缘距离。方法:选取2018年7月至2020年6月因原发性肝癌行荧光腹腔镜肝脏切除术的11例患者为研究组,并选取同期行普通腹腔镜肝脏切除术的24例原发性肝癌患者为对照组,对比两组术中发现微小肝内转移病灶情况及切缘距离。结果:两组分别发现术前未确认的肝内转移病例2例(2/11,2/24),在具备熟练术中B超技术的情况下,与传统腹腔镜技术相比,荧光显像技术在发现肝内转移病灶能力方面差异无统计学意义(P=0.395);但荧光显像技术较传统腹腔镜技术可确保较宽的切缘(P=0.034)。结论:吲哚菁绿荧光显像技术应用于腹腔镜肝脏肿瘤切除术中可有效确保肿瘤切缘获得较好的距离。Objective:To identify the capability difference of detecting the small intrahepatic metastases and cutting edge between indocyanine green fluorescence-guided laparoscopy and traditional laparoscopy during hepatectomy.Methods:Clinical data of patients who underwent laparoscopic hepatectomy for primary liver cancer between Jul.2018 and Jun.2020 were retrospectively analyzed.Eleven cases received fluorescence-guided laparoscopy and twenty-four patients received traditional laparoscopy.Detection of small intrahepatic metastases and the surgical margin were compared between the two groups.Results:Two cases were detected intrahepatic metastases in two groups respectively,there was no statistical difference in the capability of detecting intrahepatic metastases by fluorescence-guided laparoscopy compared with traditional laparoscopy(P=0.395) in case of skilled intraoperative ultrasound.However,the application of fluorescence imaging technique could ensure a wider surgical margin than traditional laparoscopy(P=0.034).Conclusions:The application of indocyanine green fluorescence imaging in laparoscopic hepatectomy can effectively ensure a sufficient resection margin.

关 键 词：肝肿瘤 肝切除术 腹腔镜检查 吲哚菁绿 荧光显像 

分 类 号：R735.7[医药卫生—肿瘤]