吲哚菁绿荧光引导腹腔镜结直肠癌根治术治疗结直肠癌的疗效及安全性

Efficacy and Safety of Indocyanine Green Fluorescence-guided Laparoscopic Radical Resection for Colorectal Cancer

目的探讨吲哚菁绿荧光引导腹腔镜结直肠癌根治术治疗结直肠癌的疗效及安全性。方法选取2019年1月至2021年1月于邢台市第三医院行腹腔镜结直肠癌根治术的101例结直肠癌患者为研究对象,根据治疗方式不同分为对照组(51例)和观察组(50例)。对照组直接行腹腔镜结直肠癌根治术,观察组则在吲哚菁绿荧光引导下行腹腔镜结直肠癌根治术。比较两组患者的手术相关指标,手术前后的生活质量,围手术期和术后并发症发生情况以及术后1年相关指标。结果观察组患者术中出血量少于对照组[(54±9)ml比(58±8)ml](P<0.05),首次下床时间、首次进食时间、首次排气时间及住院时间均短于对照组[(26±4)h比(28±5)h、(56±6)h比(59±7)h、(28.9±2.9)h比(30.3±3.1)h、(6.6±1.4)d比(7.5±1.7)d](P<0.05或P<0.01)。手术前后生活质量评分的主效应差异有统计学意义(P<0.01),不考虑测量时间,两组间的主效应差异有统计学意义(P<0.01),组间和时点间不存在交互作用(P>0.05);术后1个月,两组患者生活质量评分均明显下降,但观察组明显高于对照组(P<0.05);术后1年,两组患者生活质量评分均明显高于术前和术后1个月,且观察组高于对照组(P<0.05)。观察组腹腔感染、吻合口瘘发生率明显低于对照组[4.00%(2/50)比17.65%(9/51),2.00%(1/50)比15.69%(8/51)](P<0.05)。两组患者术后1年的局部复发率、远处转移率及生存率比较差异无统计学意义(P>0.05)。结论吲哚菁绿荧光导航腹腔镜结直肠癌根治术治疗结直肠癌可有效减少术中出血量,利于患者术后恢复,且安全可行,对提高患者术后生活质量具有积极意义。

Objective To explore the efficacy and safety of indocyanine green fluorescence guided laparoscopic radical resection for colorectal cancer.Methods A total of 101 patients with colorectal cancer who underwent laparoscopic radical resection of colorectal cancer in Xingtai Third Hospital from Jan.2019 to Jan.2021 were included and divided into a control group(51 cases)and an observation group(50 cases)according to different treatment methods.The control group received laparoscopic radical resection of colorectal cancer directly,while the observation group received indocyanine green fluorescence guided laparoscopic radical resection of colorectal cancer.The operation-related indexes,quality of life before and after surgery,perioperative and postoperative complications,and related indexes 1 year after surgery were compared between the two groups.Results The intraoperative blood loss in the observation group was less than that in the control group[(54±9)ml vs(58±8)ml](P<0.05).The first time to get out of bed,the first time to eat,the first time to exhaust and the length of hospital stay were shorter than the control group[(26±4)h vs(28±5)h,(56±6)h vs(59±7)h,(28.9±2.9)h vs(30.3±3.1)h,(6.6±1.4)d vs(7.5±1.7)d](P<0.05 or P<0.01).The main effect difference of quality of life score before and after surgery was statistically significant(P<0.01);regardless of the measurement time,the main effect difference between the two groups was statistically significant(P<0.01),and there was no interaction between the groups and time points(P>0.05).One month after surgery,the quality of life scores of both groups decreased significantly,but the observation group was significantly higher than the control group(P<0.05).One year after surgery,the quality of life scores in both groups were significantly higher than those before surgery and one month after surgery,and the observation group was higher than the control group(P<0.05).The incidences of abdominal infection and anastomotic leakage in the observation group were significantly lower than those in the control group[4.00%(2/50)vs 17.65%(9/51),2.00%(1/50)vs 15.69%(8/51)](P<0.05).There was no significant difference in the local recurrence rate,distant metastasis rate and survival rate one year after surgery between the two groups(P>0.05).Conclusion Inyanine green fluorescence guided laparoscopic radical resection of colorectal cancer can effectively reduce intraoperative blood loss,which is conducive to postoperative recovery,and is safe and feasible,with significance for improving patients′postoperative quality of life.