Watanabe Makoto, Tsunoda Akira, Narita Kazuhiro, Kusano Mitsuo, Miwa Mitsuharu
Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
Surg Today. 2009;39(3):214-8. doi: 10.1007/s00595-008-3849-9. Epub 2009 Mar 12.
We investigated the feasibility of a fluorescence imaging technique using light-emitting diode (LED)-activated indocyanine green (ICG) fluorescence.
Indocyanine green injections were given to patients undergoing preoperative colonoscopy for early colon cancer or colon adenoma. During subsequent laparotomy, the colon was first observed with the naked eye, and then using a prototype machine with a charge-coupled device (CCD) video camera equipped with a cutoff filter and a LED at a wavelength of 760 nm as the light source.
LED-induced fluorescence showed tumor localization clearly and accurately in all ten patients (100%) enrolled in this study, whereas it was seen with the naked eye as a green spot in only two patients (20%) (P = 0.0077; Wilcoxon's signed-rank test). There were no complications of LED-induced fluorescence and no inflammatory signs were noted on the hematoxylin-eosin-stained slides for the identified injection sites in the resected specimens.
Colonic tattooing using this fluorescence imaging technique of LED-activated ICG fluorescence is a new concept of colonic marking based on the characteristics that ICG is a near infrared fluorescent dye, and is useful, without any adverse effects, to identify perioperatively the tumor localization.
我们研究了使用发光二极管（LED）激活的吲哚菁绿（ICG）荧光成像技术的可行性。
对接受早期结肠癌或结肠腺瘤术前结肠镜检查的患者注射吲哚菁绿。在随后的剖腹手术中，首先用肉眼观察结肠，然后使用一台原型机器，该机器配备有电荷耦合器件（CCD）摄像机，带有截止滤光片和波长为760nm的LED作为光源。
在本研究纳入的所有10名患者（100%）中，LED诱导的荧光均清晰准确地显示了肿瘤定位，而肉眼仅在2名患者（20%）中看到绿色斑点（P = 0.0077；Wilcoxon符号秩检验）。在切除标本中，LED诱导的荧光未出现并发症，在苏木精-伊红染色切片上也未发现已确定注射部位的炎症迹象。
使用这种LED激活的ICG荧光成像技术进行结肠纹身是一种基于ICG是近红外荧光染料这一特性的结肠标记新概念，在围手术期识别肿瘤定位方面有用且无任何不良反应。
