吲哚菁绿荧光双显技术评估胸腔镜肺段切除术中肿瘤切缘的临床应用

Application of indocyanine green fluorescence dual-visualization technique in evaluating intraoperative tumor margins during the thoracoscopic segmentectomy

目的分析吲哚菁绿荧光双显技术评估胸腔镜肺段切除术中肿瘤切缘的效果。方法回顾性纳入2020年12月—2021年6月在南京医科大学附属脑科医院胸外科采用吲哚菁绿荧光双显技术进行胸腔镜解剖性肺段切除术患者36例,其中男15例、女21例,年龄20~69岁。分析全组患者的临床资料。结果吲哚菁绿荧光双显技术在术中均清晰呈现出肺结节位置及段间平面交界线,无吲哚菁绿相关并发症,平均手术时间(98.6±21.3)min,平均术中出血量(47.1±35.3)mL,术后平均引流管放置时间(3.3±2.8)d,术后平均住院时间(5.4±1.8)d,平均肿瘤切缘距离(2.6±0.7)cm,无围术期死亡,1例患者发生术后持续性肺漏气。结论吲哚菁绿荧光双显技术评估胸腔镜肺段切除术中肿瘤切缘安全可行,可简化手术流程,缩短手术时间,保证足够肿瘤切缘的同时,最大程度保留健康肺组织,为胸腔镜解剖性肺段切除术提供可靠的技术保障。

Objective To analyze the effect of indocyanine green(ICG)fluorescence dual-visualization technique on evaluating tumor margins during the thoracoscopic segmentectomy.Methods A total of 36 patients who underwent thoracoscopic anatomical segmentectomy using ICG fluorescence dual-visualization technique in our hospital from December 2020 to June 2021 were retrospectively included.There were 15 males and 21 females aged from 20 to 69 years.The clinical data of the patients were retrospectively analyzed.Results The ICG fluorescence dual-visualization technique clearly showed the position of lung nodules and the plane boundary line between segments during the operation.There was no ICG-related complication.The average operation time was 98.6±21.3 min,and the average intraoperative bleeding amount was 47.1±35.3 mL,the average postoperative drainage tube placement time was 3.3±2.8 d,the average postoperative hospital stay was 5.4±1.8 d,and the average tumor resection distance was 2.6±0.7 cm.There was no perioperative period death,and one patient suffered a persistent postoperative air leak.Conclusion The ICG fluorescence dual-visualization technique is safe and feasible for evaluating the tumor margins during thoracoscopic segmentectomy.It simplifies the surgical procedure,shortens the operation time,ensures sufficient tumor margins,and reserves healthy pulmonary parenchyma to the utmost extent,providing reliable technical support for thoracoscopic anatomical segmentectomy.