吲哚菁绿荧光导航在儿童肾盂成形术后再梗阻中的初步应用  

Applications of indocyanine green fluorescence navigation in failed pyeloplasty in children

作　　者：高晓峰 朱士博 周锐 唐向亮 束方鹏 赵天鑫 贾炜 刘国昌 伏雯 Gao Xiaofeng;Zhu Shibo;Zhou Rui;Tang Xiangliang;Shu Fangpeng;Zhao Tianxin;Jia Wei;Liu Guochang;Fu Wen(Department of Pediatric Urology,Guangzhou Women and Children Medical Center,Guangzhou 510623,China)

机构地区：[1]广州市妇女儿童医疗中心小儿泌尿外科,510623

出　　处：《中华腔镜泌尿外科杂志(电子版)》2025年第1期31-35,共5页Chinese Journal of Endourology(Electronic Edition)

基　　金：国家自然科学基金(82200742)。

摘　　要：目的探讨吲哚菁绿荧光导航技术在儿童肾盂成形术后再梗阻中的应用价值。方法自2019年1月至2021年6月共收集34例肾盂成形术后再梗阻的临床资料,所有患儿均采用腹腔镜再次肾盂成形术,按照术中是否应用吲哚菁绿荧光导航将患儿分为观察组(15例)和对照组(19例)。观察组在吲哚菁绿荧光导航技术下完成腹腔镜再次肾盂成形术,对照组采用常规腹腔镜再次肾盂成形术,比较两组在一般资料、手术时间、术中出血量、手术成功率及术后住院天数等方面的差异。结果34例患儿手术均顺利完成,无中转开放。观察组手术时间(167±4)min,同对照组手术时间(182±4)min相比,差异具有统计学意义(P=0.011),而在术中出血量、手术成功率及术后住院天数等方面差异无统计学意义(P>0.05)。观察组15例患儿经输尿管逆行置管注入吲哚菁绿荧光后均成功显示输尿管,平均用时(7±1)min。两组患儿均获得随访,时间12~24个月,与术前对照,肾积水均明显改善或稳定,术后无并发症。结论吲哚菁绿荧光导航在儿童肾盂成形术后再梗阻手术中对患侧输尿管进行快速识别和精准导航是简便、安全、可行的方法,可以加快手术进度。Objective To investigate the application value of indocyanine green fluorescence navigation in failed pyeloplasty in children.Methods From January 2019 to June 2021,clinical data of 34 cases of recurrent ureteropelvic junction obstruction after pyeloplasty was collected.All children underwent laparoscopic re-pyeloplasty were divided into observation group(15 cases)and control group(19 cases)according to whether indocyanine green fluorescence was used during the operation.Patients in observation group underwent laparoscopic re-pyeloplasty under indocyanine green fluorescence,while the patients in control group underwent conventional laparoscopic re-pyeloplasty.The differences between the two groups in terms of common data,operation time,intraoperative blood loss,operation successful rate and postoperative hospital stay were compared.Results All 34 children were completed the operation successfully without conversion to open surgery.The total operation time in the observation group(167±4)min was significantly different from that in the control group(182±4)min(P=0.011),while there was no significant difference in intraoperative blood loss,operation successful rate and postoperative hospital stay(P>0.05).The ureters of 15 patients in observation group were successfully displayed after indocyanine green fluorescence staining with a mean time of(7±1)min.The children in both groups were followed up for 12-24 months.Compared with those before operation,hydronephrosis was obviously improved or stabilized after operation without postoperative complications.Conclusions Indocyanine green fluorescence imaging technique is a simple,safe and feasible method for rapid identification and precise navigation of the affected ureter during the reoperation for failed pyeloplasty in children,which can accelerate the progress of surgery.

关 键 词：吲哚菁绿 荧光导航 肾盂成形术 再梗阻 肾积水 

分 类 号：R726.9[医药卫生—儿科]