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吲哚菁绿荧光成像技术在小肝癌切除线规划及实时手术导航中的应用

[Application of indocyanine green-fluorescent imaging technique in planning resection line and real-time surgical navigation in small hepatocellular carcinoma].

作者信息

Fang C H, Liang H B, Chi C W, Tao H S, Fang C, Zhu W, Mo Z K, Yang J, Xiang N, Zeng N, Tian J

机构信息

First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2016 Jun 1;54(6):444-450. doi: 10.3760/cma.j.issn.0529-5815.2016.06.011.

Abstract

To explore the value of near-infrared technology guided by indolecyanine green(ICG) in planning resection line and real-time surgical navigation in small liver cancer. From March to September 2015, 11 patients with hepatic tumors received hepatectomy were treated in First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University.There were 5 male and 6 female patients with average age of (55±10)years (range 39-70 years). Among whom, there were 9 cases with hepatocellular carcinoma and 2 cases with colorectal cancer. A near-infrared light camera system was used to detect the liver surfaces before resection, and to plan resection line and surgical specimens. A student's test was used to compare continuous parametric variables. The ICG-fluorescent imaging and histological examination had been used in the 15 lesions of the 11 patients. Among the 15 lesions, 7 lesions were detected by visual inspections, palpation and ICG-fluorescent imaging, 6 lesions were identified only by ICG-fluorescent imaging, 2 lesions were detected only by ICG-fluorescent imaging after resection.Results of pathologic examination indicated that the total fluorescent type include 5 well differentiated hepatocellular carcinoma and 2 cirrhotic nodule; the partial fluorescent type include 3 moderately differentiated hepatocellular carcinomas and 1 well differentiated hepatocellular carcinomas; the rim fluorescent type included 2 liver metastatic carcinoma and 2 poorly differentiated hepatocellular carcinomas. The average diameter of the tumor size measured by CT was (1.7±0.2)cm, while the average diameter measured by ICG-fluorescent imaging was (1.7±0.3)cm(=-0.188, >0.05). Near-infrared technology guided by ICG has important value in planning resection line and real-time surgical navigation in small liver cancer.

摘要

探讨吲哚菁绿(ICG)引导的近红外技术在小肝癌切除线规划及实时手术导航中的价值。2015年3月至9月,南方医科大学珠江医院肝胆外科一区对11例接受肝切除术的肝肿瘤患者进行了治疗。男性5例,女性6例,平均年龄(55±10)岁(范围39 - 70岁)。其中肝细胞癌9例,结直肠癌2例。术前使用近红外光摄像系统检测肝脏表面,规划切除线及手术标本。采用学生t检验比较连续参数变量。11例患者的15个病灶均采用ICG荧光成像及组织学检查。15个病灶中,7个病灶通过视觉检查、触诊及ICG荧光成像检测到,6个病灶仅通过ICG荧光成像识别,2个病灶在切除后仅通过ICG荧光成像检测到。病理检查结果显示,全荧光型包括5例高分化肝细胞癌和2例肝硬化结节;部分荧光型包括3例中分化肝细胞癌和1例高分化肝细胞癌;边缘荧光型包括2例肝转移癌和2例低分化肝细胞癌。CT测量的肿瘤平均直径为(1.7±0.2)cm,而ICG荧光成像测量的平均直径为(1.7±0.3)cm(t=-0.188,P>0.05)。ICG引导的近红外技术在小肝癌切除线规划及实时手术导航中具有重要价值。

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