腹部术中输尿管实时识别研究进展

Research progress of real-time identification of ureter during abdominal surgery

在腹部外科手术过程中,医源性输尿管损伤虽然较罕见,但是一旦发生损伤将会产生严重的并发症,如腹腔感染、输尿管瘘、肾衰竭等。为了降低腹部术中医源性输尿管损伤的风险,术中实时在体输尿管可视化的医学成像技术被广泛地研究与应用,如预防输尿管导管置入术(或发光输尿管支架置入术)、gamma探测技术、荧光成像技术。然而这些技术目前仅有荧光成像技术可以达到无创、无电离辐射、可实时在体获取输尿管的位置信息。相关研究已证实了应用荧光成像技术结合外源荧光染料的使用在腹部术中实时在体可视化输尿管位置信息的可行性,并取得重要的进展。本文就近年来应用荧光成像技术和外源荧光染料(荧光素钠、亚甲基蓝、吲哚、CW800-CA、ZW800-1)在腹部术中输尿管实时识别的研究进展做一综述。

Rare as iatrogenic ureteral injuries are during abdominal surgery, injury can cause serious complications, such as abdominal infection, ureter fistula, kidney failure, etc. In order to reduce the risk of iastrogenic ureteral injury, medical imaging technologies which enable real-time ureter visualization have been widely studied and clinically applied, such as prophylactic ureteral catheterization（or luminant ureteral stent）, gamma detection technique, and fluorescence imaging technology. However, at present only fluorescence imaging technology can acquire the location information through real-time ureter visualization while being non-invasive and having no ionizing radiation. Relevant studies have proved that real-time identification of the ureter during surgery using fluorescence imaging technology combined with exogenous fluorescence dye is feasible and have made important progresses. This review summarizes the recent progress in the research of real-time identification of ureter using fluorescence imaging technology and exogenous fluorescent dye（fluorescein sodium, methylene blue, indocyanine, CW800-CA, and ZW800-1） during abdominal surgery.