4K荧光单孔胸腔镜解剖性肺段切除术在肺小结节中的应用  

Application of 4K fluorescence single-port thoracoscopic anatomical segmentectomy in small pulmonary nodules

作　　者：汪志海 林苗苗[1] 杨坤[1] 耿耿 陶勇[1] WANG Zhi-hai;LIN Miao-miao;YANG Kun;GENG Geng;TAO Yong(Department of Thoracic and Cardiovascular Surgery,Wuhu Hospital,East China Normal University/Wuhu Second People's Hospital,Wuhu Anhui 241000,China)

机构地区：[1]华东师范大学附属芜湖医院/芜湖市第二人民医院胸心外科,安徽芜湖241000

出　　处：《局解手术学杂志》2025年第4期337-341,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：芜湖市卫生健康委科研项目(WHWJ2021y047)。

摘　　要：目的分析吲哚菁绿(ICG)荧光显影技术在胸腔镜解剖性肺段切除术中的可行性和优势。方法选择2023年1月至2024年6月于我科行胸腔镜解剖性肺段切除术的肺小结节患者,根据段间平面识别方法的不同分为ICG荧光组35例(采用ICG荧光显影法识别段间平面)及改良膨胀萎陷组42例(采用改良膨胀萎陷法识别段间平面)。统计2组患者段间平面出现时间、手术时间、淋巴结清扫数目、术后胸管时间、术后住院时间等手术相关指标及并发症发生情况。选取2组60岁以上患者,并分析其手术相关指标的差异。结果ICG荧光组患者段间平面出现时间及手术时间均短于改良膨胀萎陷组,差异有统计学意义(P<0.05)。2组患者淋巴结清扫数目、术后胸管时间、术后住院时间比较,差异均无统计学意义(P>0.05)。2组术后并发症发生率比较,差异无统计学意义(P>0.05)。ICG荧光组60岁以上患者的段间平面出现时间、手术时间及术后住院时间均短于改良膨胀萎陷组,差异有统计学意义(P<0.05)。结论ICG荧光显影法能够清晰快速地显示段间平面,可缩短老年肺结节患者的段间平面出现时间和住院时间。Objective To analyze the feasibility and advantage of indocyanine green(ICG)fluorescence imaging technique in the thoracoscopic anatomical segmentectomy.Methods Patients with small pulmonary nodules who underwent thoracoscopic anatomical segmentectomy in our department from January 2023 to June 2024 were selected and divided into the ICG fluorescence group(35 cases determining intersegmental plane through ICG fluorescence imaging method)and the modified inflation-deflation group(42 cases determining intersegmental plane through modified inflation-deflation method)according to different methods of determining intersegmental plane.The surgery-related indicators including time of intersegmental plane occurrence,operation time,number of lymph node dissection,postoperative duration of chest tube and postoperative hospital stay as well as the occurrence of complications in the two groups were counted.Patients over 60 years old in two groups were selected and the differences in surgery-related indicators were analyzed.Results The time of intersegmental plane occurrence and operation time in the ICG fluorescence group were shorter than those in the modified inflation-deflation group,with statistically significant differences(P<0.05).There was no significant difference in the number of lymph node dissection,postoperative duration of chest tube or postoperative hospital stay between the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).The time of intersegmental plane occurrence,operation time and postoperative hospital stay of patients over 60 years old in the ICG fluorescence group were shorter than those in the modified inflation-deflation group,with statistically significant differences(P<0.05).Conclusion ICG fluorescence imaging method can display the intersegmental plane clearly and quickly,which can shorten the time of intersegmental plane occurrence and hospital stay in elderly patients with pulmonary nodules.

关 键 词：吲哚菁绿 胸腔镜 肺段切除术 改良膨胀萎陷法 

分 类 号：R655.3[医药卫生—外科学]