吲哚菁绿荧光成像技术在完全腹腔镜结肠癌手术中的应用  

Clinical application of indocyanine green fluorescence imaging in totally laparoscopic colon cancer surgery

作　　者：徐明月[1] 陈媛媛[2] 赵丽[3] 杨洁[1] 刘庆[1] 闻巍[1] 乔治[1] XU Ming-yue;CHEN Yuan-yuan;ZHAO Li(Department of General Surgery,Hainan Hospital of Chinese PLA General Hospital,Sanya 570013,China;Department of General Practice,Hainan Hospital of Chinese PLA General Hospital;Department of Gastroenterology,Hainan Hospital of Chinese PLA General Hospital)

机构地区：[1]解放军总医院海南医院普通外科,海南三亚570013 [2]解放军总医院海南医院全科医学科 [3]解放军总医院海南医院消化内科

出　　处：《腹腔镜外科杂志》2022年第2期120-123,129,共5页Journal of Laparoscopic Surgery

基　　金：中国人民解放军总医院科技创新苗圃基金项目(18KMM42);海南省自然科学基金面上项目(820MS125)。

摘　　要：目的:探讨吲哚菁绿荧光成像技术在完全腹腔镜结肠癌手术中的应用价值。方法:回顾分析2018年1月至2020年2月行完全腹腔镜手术并经病理确诊的结肠癌患者的临床资料,其中研究组37例(吲哚菁绿荧光成像),对照组39例(传统腹腔镜或3D腹腔镜手术),对比分析两组患者病理特征、手术及术后并发症情况。结果:两组患者年龄、性别、BMI、ASA分级、肿瘤部位、术前合并症差异均无统计学意义(P>0.05)。研究组中位手术时间短于对照组(184 min vs.200 min),差异有统计学意义(P<0.05);淋巴结清扫数量多于对照组[(27.5±4.1)vs.(23.7±5.0)],差异有统计学意义(P<0.05)。两组均未出现吻合口狭窄、吻合口漏等严重并发症,两组手术并发症、术后住院时间差异无统计学意义。结论:吲哚菁绿荧光成像技术在完全腹腔镜结肠癌手术中是安全、可行的,有助于目标肠段的定位及吻合口血供的快速判断,可缩短手术时间,减少吻合口漏的发生。Objective:To investigate the clinical application of indocyanine green fluorescence imaging in totally laparoscopic colon cancer surgery.Methods:Clinical data of colon cancer patients from Jan.2018 to Feb.2020 were retrospectively analyzed,the colon cancer was confirmed by pathology.There were 37 patients in study group who received indocyanine green fluorescence imaging,and 39 patients in control group who underwent traditional or 3D laparoscopic operation.Clinical pathological characteristics,operative details and postoperative complications between the two groups were compared.Results:There were no statistically significant differences between the two groups in age,sex,BMI,ASA grade,tumor site,and other diseases before operation.The median operative time in the study group was significantly shorter than that in the control group(184 min vs.200 min)with statistically significant difference(P<0.05).The number of lymph node dissected in the study group was significantly more than that in the control group[(27.5±4.1)vs.(23.7±5.0)]with statistically significant difference(P<0.05).No severe complications such as anastomotic stenosis or anastomotic leakage occurred,and there was no statistical difference between the two groups in terms of surgical complications and postoperative hospital stay.Conclusions:Indocyanine green fluorescence imaging in totally laparoscopic resection for colon cancer is safe,feasible and helpful to the tumor location and rapid determination of anastomotic blood supply,and could shorten operation time and reduce the incidence of anastomotic leakage.

关 键 词：结肠肿瘤 腹腔镜检查 吲哚菁绿 荧光成像 

分 类 号：R735.35[医药卫生—肿瘤]