吲哚菁绿荧光显影技术辅助腹腔镜下结直肠癌肝转移切除的应用价值

Application value of indocyanine green fluorescence fusion imaging in the laparoscopic resection of liver metastases from colorectal cancer

目的探讨吲哚菁绿荧光显影技术辅助腹腔镜下结直肠癌肝转移切除的应用价值。方法采用回顾性分析湖南省人民医院肝胆微创外科和结直肠外科2018年7月至2019年12月实施的9例吲哚菁绿荧光显影技术辅助腹腔镜下结直肠癌肝转移切除的临床资料。结果9例病人均在吲哚菁绿荧光显影技术辅助腹腔镜下完成手术,无中转开腹病人。平均手术时间为285 min(225~350 min);术中平均失血量为163 ml(50~320 ml),术中输血1例;手术后住院8~18 d,平均12 d;术后所有病人均未发生严重并发症。随访5~22个月,中位随访时间13个月,其中1例病人术后肝转移瘤再发并再次予以手术切除。结论吲哚菁绿荧光显影技术辅助腹腔镜下结直肠癌肝转移瘤切除是安全和可行,近期疗效尚可,但尚需更多病例和更长随访时间进一步论证。

Objective To investigate the clinical value of indocyanine green fluorescence imaging technique assisted laparoscopic resection of colorectal liver metastases.Methods The clinical data of 9 cases of laparoscopic resection of colorectal liver metastases assisted by indocyanine green fluorescence imaging technique from July 2018 to December 2019 in the Department of Hepatobiliary Minimally Invasive Surgery and Colorectal Surgery,Hunan Provincial People's Hospital were retrospectively analyzed.Results All cases were successfully completed laparoscopy assisted by indocyanine green fluorescence imaging technique,and there was no conversion to laparotomy.The surgical duration was 225-350 min,with an average one of 285 min;the intra-operative hemorrhagic volume was 50-320 ml,with an average one of 163 ml;1 patient had intra-operative blood transfusion;the hospital stay was 8-18 d,with an average one of 12 d.None had postoperative severe complications.The patients were followed up for 5-22 months,with a follow-up time of 13 months.One patient had recurrence after resection of liver metastases and underwent surgical resection again.Conclusion Indocyanine green fluorescence imaging assisted laparoscopic resection of colorectal liver metastases is safe and feasible,and the short-term efficacy is fair.However,further evidence is needed for more cases and longer follow-up time.