荧光染色技术在胸腔镜肺段切除术中的价值

目的 探讨吲哚菁绿荧光染色技术在胸腔镜解剖性肺段切除术中的应用价值。 方法 回顾性分析2018年1月至2019年12月苏州大学附属第一医院胸外科45例利用荧光染色法行胸腔镜解剖性肺段切除术患者的临床手术资料,并记录首次发出荧光时间、荧光持续时间、交界有效辨别时间。 结果 除1例肺气肿患者外,其余44例(97.78%)患者荧光染色显示出清晰的段间分界,首次发出荧光时间为(10.8±5.3)s,荧光持续时间为(179.9±40.3)s,交界有效辨别时间为(121.1±15.2)s。45例患者均成功完成肺段切除手术,平均手术时间(95.7±30.2)min,术中出血量(51.8±16.3)mL。术中均未出现吲哚菁绿相关并发症,3例患者出现术后并发症。胸腔引流放置时间(3.6±1.8)d,总住院时间(6.6±2.1)d。平均随访时间(14.5±8.7)个月,均未见复发。 结论 荧光染色技术在识别段间平面时表现出较高的安全性、准确性和便捷性,降低了肺段切除手术的难度,具有较高的临床推广价值。

Value of indocyanine green fluorescence in thoracoscopic segmentectomy

Objective To investigate the application value of indocyanine green(ICG)fluorescence in anatomical thoracoscopic segmentectomy. Methods The clinical data of 45 patients who underwent anatomical thoracoscopic segmentectomy by ICG fluorescence was retrospectively analyzed. The first appearance time, duration of fluorescence and duration of valid contrasting fluorescence were recorded. Results Apart from one patient with pulmonary emphysema, 44 patients(97.78%)showed clear demarcation lines after injecting ICG, with the first appearance time of(10.8±5.3)s and duration of(179.9±40.3)s. The mean duration of valid contrasting fluorescence was(121.1±15.2)s. All patients completed pulmonary segmentectomy successfully with the operation time of(95.7±30.2)min and bleeding volume of(51.8±16.3)mL. No obvious complications related to ICG was observed in surgery, while postoperative complications occurred in three patients. The mean drainage time was(3.6±1.8)d and the average hospitalization time was(6.6±2.1)d. All patients recovered well without recurrence at the end of follow-up, which averaged(14.5±8.7)months. Conclusion The ICG fluorescence technology is safe, accurate and convenient for identifying demarcation line. It contributes to the feasibility of the segmentectomy. Therefore, this technology is well worth promoting in clinic.