吲哚菁绿分子荧光成像技术在腹腔镜肝切除中的应用

目的探讨吲哚菁绿(indocyanine green,ICG)分子荧光成像技术引导腹腔镜肝切除术治疗肝细胞癌的安全性和有效性,以及对远期预后的影响。方法回顾性分析2016年8月至2019年9月期间229例接受单纯腹腔镜肝切除的肝细胞癌病人及69例接受ICG引导下腹腔镜肝切除的肝细胞癌病人的临床资料。采用倾向性评分匹配方法,比较两组病人的手术情况和术后并发症,采用Log-Rank检验分析两组病人的无病生存期和总生存期。结果 298例腹腔镜肝癌切除病人中,单纯腹腔镜肝切除组229例,ICG荧光引导腹腔镜肝切除术组69例,1∶1匹配后两组均有65例病人纳入分析。配对前、后,ICG荧光引导腹腔镜肝切除术组手术时间均短于单纯腹腔镜肝切除组(均P<0.05);术中出血量、术中输血量、术后并发症、无病生存期和总生存期两组间差异均无统计学意义(均P>0.05)。结论 ICG分子荧光成像技术可作为腹腔镜肝切除中有效的实时导航手段,可明显缩短手术时间,且并未增加术后并发症,同时可获得与单纯腹腔镜肝切除相当的远期预后。

Application of indocyanine green fluorescence imaging in laparoscopic hepatectomy

Objective To investigate the safety and efficacy of ICG fluorescence guided laparoscopic hepatectomy for hepatocellular carcinoma(HCC).Methods From August 2016 to September 2019,229 patients who underwent conventional laparoscopic liver resection(LLR)and 69 patients who underwent ICG fluorescence guided laparoscopic liver resection(FLLR)were retrospectively analyzed.Propensity score matching(PSM)method was used to compare the surgical conditions and postoperative complications between the two groups,and Log-Rank test was used to analyze the disease-free survival(DFS)and overall survival(OS)of the two groups.Results Among 298 patients with laparoscopic hepatectomy,229 patients in LLR group and 69 patients in FLLR group were included in the study,with 65 patients in both groups after matching.The operation time of FLLR group was shorter than that of LLR group both before and after pairing(P<0.05);there was no statistical difference between the two groups before and after matching,such as intraoperative hemorrhage,intraoperative blood transfusion,postoperative complications,DFS and OS.Conclusion ICG fluorescence imaging guided laparoscopic hepatectomy can effectively shorten the operation time without increasing postoperative complications,and has the same effect as laparoscopic hepatectomy alone in the long-term prognosis of tumors.