吲哚菁绿在进展期胃癌腹腔镜手术中的安全性和有效性

Feasibility and efficacy of indocyanine green used in laparoscopic gastrectomy for advanced gastric cancer patients

目的研究吲哚菁绿(ICG)在进展期胃癌腹腔镜手术中的安全性和有效性。方法回顾性分析中国医学科学院肿瘤医院胰胃外科2018年12月至2019年8月收治的82例临床分期为进展期行腹腔镜根治性切除术胃癌患者的资料,分为ICG组(38例)和常规手术组(44例)。对比两组患者的淋巴结清扫个数、手术时间、术中出血量、术后排气时间、发热时间、住院时间和并发症发生情况。结果ICG组和常规手术组患者的手术时间分别为(172.8±45.8)min和(162.6±45.7)min,术中出血量分别为(80.1±91.9)ml和(78.6±89.8)ml,术后住院时间分别为(7.0±2.0)d和(7.5±2.4)d,术后发热时间分别为(2.3±1.2)d和(2.9±1.9)d,术后排气时间分别为(3.4±0.8)d和(3.4±1.1)d,术后并发症的发生率分别为5.3%(2/38)和9.1%(4/44),差异均无统计学意义(均P>0.05)。ICG组患者的淋巴结清扫数为46.5枚,较常规手术组(33.0枚)增加(P=0.005)。结论ICG在进展期胃癌患者的腹腔镜手术中应用安全可靠,可能增加区域淋巴结的清扫数量。

Objective To identify the feasibility and efficacy of indocyanine green(ICG)used in laparoscopic gastrectomy for advanced gastric cancer patients.Methods From December 2018 to August 2019,the clinical data of 82 patients preoperatively diagnosed as advanced gastric cancer undergoing laparoscopic radical gastrectomy were retrospectively analyzed.These patients were divided into ICG group(n=38)and a historical control group(non-ICG group,n=44).The number of retrieved lymph nodes,operation time,blood loss,hospital stay,fever time,evacuation time and complications were compared between these two groups.Results The operation time[(172.8±45.8)min vs(162.6±45.7)min],blood loss[(80.1±91.9)ml vs(78.6±89.8)ml],hospital stay[(7.0±2.0)d vs(7.5±2.4)d],fever time[(2.3±1.2)d vs(2.9±1.9)d],evacuation time[(3.4±0.8)d vs(3.4±1.1)d]and incidence of complications(5.3%vs 9.1%)were not significantly different between the ICG and historical control groups(P>0.05).The number of retrieved lymph nodes in ICG group was significantly increased compared with that of the historical control group(46.5 vs 33.0,P=0.005).Conclusions The ICG method applied in lymph node dissection of laparoscopic radical gastrectomy is safe.Moreover,ICG might elevate the efficiency of regional lymph node dissection.