吲哚菁绿荧光显像在腹腔镜膀胱癌根治术淋巴结精准清扫中的应用  

Application of indocyanine green fluorescence imaging in the precise dissection of lymph nodes during laparoscopic radical resection of bladder cancer

作　　者：刘利峰 郭岩松 王浩 王晓鹏 杨丰硕 胡月鹏 田龙江 LIU Lifeng;GUO Yansong;WANG Hao;WANG Xiaopeng;YANG Fengshuo;HU Yuepeng;TIAN Longjiang(Department of Urology,Cangzhou People's Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市人民医院泌尿外科,河北沧州061000

出　　处：《现代泌尿外科杂志》2024年第7期638-641,共4页Journal of Modern Urology

基　　金：河北省医学科学研究指令性课题项目(No.20220001)。

摘　　要：目的 探讨吲哚菁绿(ICG)荧光显像下行腹腔镜淋巴结精准清扫的疗效、安全性及可行性。方法 纳入2018年3月—2022年6月就诊于沧州市人民医院泌尿外科的30例肌层浸润性膀胱癌(T2/T3NxM0)患者,所有患者均先行ICG荧光显像引导下腹腔镜淋巴结精准清扫术,然后按标准淋巴结清扫范围清扫剩余淋巴结组织,自身对照分析两种淋巴结清扫方式的淋巴结阳性率。结果 自身对照分析ICG荧光显像引导下淋巴结精准清扫的手术时间较标准清扫短[(21.80±6.80)min vs.(47.70±10.73)min],差异有统计学意义(P<0.05);两种清扫方式的淋巴结平均阳性率比较差异无统计学意义[(11.34±9.06)%vs.(12.36±9.43)%,P>0.05],但前者淋巴结清扫时血管、神经损伤及输血情况发生率较后者低。结论 ICG荧光显像引导下腹腔镜淋巴结精准清扫术与标准淋巴结清扫术疗效相当,可减少无效淋巴结清扫、缩短手术时间、降低并发症风险。Objective To investigate the efficacy,safety and feasibility of laparoscopic lymph node dissection guided by indocyanine green(ICG)fluorescence imaging.Methods A total of 30 patients with muscle-invasive bladder cancer(MIBC,T2/T3NxM0)who were admitled to the Cangzhou People's Hospital during Mar.2018 and Jun.2022 were included.The lymph nodes were cleared with ICG fluorescence imaging first,and then the remaining lymph nodes were cleared according to the standard pelvic lymph node range.The lymph node positive rate of ICG fluorescence imaging guided laparoscopic lymph node precise dissection and standard pelvic lymph node dissection was analyzed by self-comparison.Results ICG fluorescence imaging guided laparoscopic lymph node precise dissection needed shorter operation time than standard pelvic lymph node dissection[(21.80±6.80)min vs.(47.70±10.73)min,P<0.05].Therewasno significant differencein thelymphnode positive rate between the two approaches[(11.34±9.06)%vs.(12.36±9.43)%,P>0.05],but the former approach caused less damage on blood vessels and nerves.Conclusion Indocyanine green fluorescence imaging guided laparoscopic lymph node dissection has comparable efficacy to standard pelvic lymph node dissection,which can reduce ineffective lymph node dissection,shorten the operation time,and reduce the risk of complications.

关 键 词：肌层浸润性膀胱癌 吲哚菁绿 盆腔淋巴结清扫术 根治性膀胱切除术 

分 类 号：R737.14[医药卫生—肿瘤]