腹腔镜下吲哚菁绿示踪前哨淋巴结在保留生育功能宫颈癌手术中的应用

目的 探讨吲哚菁绿（indocyanine green，ICG）示踪前哨淋巴结在腹腔镜下保留生育功能宫颈癌手术中的应用效果并总结经验。方法 回顾性分析24例行腹腔镜下广泛宫颈切除+示踪前哨淋巴结（sentinel lymph node，SLN）切除宫颈癌患者的临床资料，所有患者均采用ICG示踪，进行前哨淋巴结活检（sentinel lymph node biopsy，SLNB），分析显影情况、前哨淋巴结分布及数量。结果 24例患者均出现至少1个SLN显影，显影率为100%（24/24），双侧显影率为93.8%（22/24）。不同示踪剂注射方法与术前是否行子宫锥切患者的SLN显影率差异无统计学意义（Ｐ＞0.05）。24例患者共切除前哨淋巴结210枚，平均8.75枚（3~19枚），其中139枚SLN位于髂血管区域，占66.19%（139/210）。结论 在严格掌握指征和操作流程的情况下，ICG示踪前哨淋巴结可有效应用于腹腔镜下保留生育功能宫颈癌手术。

Application of indocyanine green for sentinel lymph node mapping in laparoscopic fertility-sparing surgery for cervical cancer

Objective To explore the effect of  indocyanine green（ICG）for sentinel lymph node mapping in laparoscopic fertility-sparing surgery for early cervical cancer. Methods Clinical data of 24 patients which underwent laparoscopic radical trachelectomy and sentinel lymph node biopsy were retrospectively analyzed. All patients were treated with ICG mapping. The detection rates，lymph node distribution and quantity were analyzed. Results Twenty-four  patients were included. Intraoperative ICG mapping detected at least one SLN in 24 patients （24/24），while bilateral mapping was achieved in 93.8% of cases（22/24）. There was no difference in detection rates between different injection method and patients with and without prior conization（P＞0.05）.A total of 210 SLN were resected in 24 patients，with an average of 8.75 SLN per patient（3-19 SLN）. 139 SLN are located in the iliac vessels，accounting for 66.19% （139/210）. Conclusions Sentinel lymph node mapping can be effectively applied to laparoscopic fertility-sparing surgery for early cervical cancers with strict indication and operational procedures.