吲哚菁绿荧光染色法在胸腔镜肺段切除术中的应用

Application of Indocyanine Green Fluorescent Staining Method in Thoracoscopic Segmentectomy

目的探讨荧光染色法界定段间平面在胸腔镜解剖性肺段切除术中可行性及优势。方法回顾性分析2019年1月~2020年5月在安庆市立医院胸外科进行胸腔镜解剖性肺段切除术66例肺结节患者的临床资料,根据界定段间平面方法不同将其分为对照组(40例)和实验组(26例),对照组采用改良膨胀萎陷界定段间平面,实验组采用荧光染色法界定段间平面;比较两组手术时间、术中出血量、段平面出现时间、淋巴结清扫数目、术后置管时间、住院时间及术后并发症发生情况。结果实验组手术时间短于对照组[(185.77±45.58)min vs(213.13±45.71)min],差异有统计学意义(P<0.05);实验组段间平面出现时间早于对照组[(10.62±1.88)s vs(953.58±295.20)s],差异有统计学意义(P<0.05);两组术中出血量、淋巴结清扫数目、术后置管时间、住院时间及并发症发生率比较,差异无统计学意义(P>0.05)。结论相比改良膨胀萎陷法,吲哚菁绿荧光染色法在解剖性肺段切除术中可快速、直观显示段间平面,且有效完成段间标记,有助于缩短手术时间,值得临床应用。

Objective To explore the feasibility and advantages of fluorescent staining method to define the inter-segment plane in thoracoscopic anatomical segmentectomy.Methods A retrospective analysis of the clinical data of 66 patients with pulmonary nodules underwent thoracoscopic anatomical segmentectomy in the Department of Thoracic Surgery of Anqing Municipal Hospital from January 2019 to May 2020.According to the different methods of defining the plane between segments,they are divided into a control group(40 cases)and an experimental group(26 cases).The control group used modified expansion and collapse to define the inter-segment plane,and the experimental group used the fluorescent staining method to define the inter-segment plane;The operation time,intraoperative blood loss,segment plane appearance time,number of lymph node dissection,postoperative catheterization time,hospital stay and postoperative complications were compared between the two groups.Results The operation time of the experimental group was shorter than that of the control group[(185.77±45.58)min vs(213.13±45.71)min],the difference was statistically significant(P<0.05);The appearance time of the inter-segment plane in the experimental group was earlier than that in the control group[(10.62±1.88)s vs(953.58±295.20)s],the difference was statistically significant(P<0.05);There was no statistically significant difference in the amount of blood loss,the number of lymph node dissections,postoperative catheterization time,hospital stay and complication rate between the two groups(P>0.05).Conclusion Compared with the modified dilation and collapse method,the indocyanine green fluorescence staining method can quickly and intuitively display the inter-segment plane in anatomical lung resection,and effectively complete the inter-segment marking,which helps to shorten the operation time and is worthy of clinical application.