吲哚菁绿荧光导航和三维可视化腹腔镜精准手术治疗原发性肝癌患者应用研究*

目的 探讨应用吲哚菁绿荧光导航和三维可视化精准手术治疗原发性肝癌(PLC)患者的应用价值。方法 2015年1月～2019年12月我院收治的PLC患者114例,采用随机数字表法分为对照组57例和观察组57例,分别行吲哚菁绿荧光导航和腹腔镜下肝癌切除术或吲哚菁绿荧光导航和三维可视化腹腔镜下肝癌切除术。采用放射免疫法测定血清皮质醇(COR)水平,采用ELISA法测定血清白介素-6(IL-6)水平。结果 观察组住院时间为(6.9±2.3)d,与对照组比较差异无统计学意义【(7.5±2.5)d,P>0.05】,两组荧光染色满意率分别为91.2%和91.2%(P>0.05),观察组手术时间和术中出血量分别为(181.0±59.6)min和(96.9±21.7)ml,显著短于或少于对照组分别为【(210.4±86.5)min和(106.3±25.0)ml,P<0.05】;两组手术前后肝功能指标比较,无显著性差异(P<0.05);术后,观察组血清COR和IL-6水平分别为(264.3±33.8)mmol/L和(108.0±13.8)pg/ml,显著低于对照组【(288.0±34.5)mmol/L和(116.1±15.8)pg/ml,P<0.05】;术后,两组胆漏、胸腹腔积液和发热等围术期并发症发生率(24.6%对36.8%)比较,差异无统计学意义(P>0.05)。结论 采用吲哚菁绿荧光导航技术和三维可视化腹腔镜下肝癌精准切除术治疗PLC患者,有利于精准切除肿瘤,缩短手术时间,值得进一步研究。

Application of indocyanine green fluorescence navigationand three-dimensional visualization in laparoscopic precision surgery for patients with primary liver cancer

Objective The aim of this study was to investigate the application of indocyanine green fluorescence navigation technology and three-dimensional visualization in laparoscopic precision surgery for patients with primary liver cancer (PLC). Methods A total of 114 patients with PLC were admitted to our hospital between January 2015 and December 2019, and were randomly divided into observation (n=57) and control group (n=57). The patients in the control received indocyanine green fluorescence navigation and laparoscopic hepatectomy and those in the combination received indocyanine green fluorescence navigation and laparoscopic hepatectomy under three-dimensional visualization. Serum cortisol (COR) and interleukin 6 (IL-6) were detected. Results The hospital stay were(6.9±2.3)d and (7.5±2.5)d (P>0.05) in the combination and control group, the satisfaction rates of fluorescent staining in the two groups were 91.2% and 91.2%(P>0.05), while the operation time and blood loss in the combination were (181.0±59.6)min and (96.9±21.7)ml, both significantly shorter or less than (210.4±86.5)min and (106.3±25.0)ml, respectively,P<0.05] in the control; there was no significant differences as respect to the liver function tests between the two groups (P<0.05); after operation, serum COR and IL-6 levels in the combination were (264.3±33.8)mmol/L and (108.0±13.8)pg/ml, both significantly lower than (288.0±34.5)mmol/L and (116.1±15.8)pg/ml, respectively, P<0.05] in the control; after operation, the incidences of bile leakage, pleural effusion and ascites, and fever in the two groups were 24.6% vs. 36.8%, without significant differences (P>0.05). Conclusion The application of indocyanine green fluorescence navigation technology and laparoscopic hepatectomy under three-dimensional visualization might help remove the tumors precisely and shorten operational times, which warrants more clinical observations.