Department of General and Colorectal Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain; Department of Emergency and General Surgery, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
Department of General, Emergency and Minimally Invasive Surgery, Policlinico Universitario "D. Casula", Cagliari, Italy.
HPB (Oxford). 2020 Mar;22(3):422-431. doi: 10.1016/j.hpb.2019.07.013. Epub 2019 Aug 10.
The fluorescence properties of Indocyanine Green (ICG) make it a useful technique in the armamentarium of liver surgeons in order to enhance the visualization of anatomical structures by providing a real-time liver mapping.
We have analyzed the impact of ICG-fluorescence staining technique in 40 consecutive patients who underwent robotic-assisted liver resection for malignancies from June 2014 to November 2017.
For the 55% of patients the surgical indication was colorectal liver metastasis followed by hepatocarcinoma in 35% of cases. The R0 resection rate was 100%, and the mean resection margin was 12 mm. Twenty percent of patients experienced tumor recurrence. The 1-year and 2-year overall survival rates were 91% and 84%, respectively. The 1-year and 2-year disease free survival were 77.2% and 65%, respectively. The previously marked transaction line was changed after the staining method in 12 out of 40 patients. Through intra-operative ultrasonography and white-light exploration of the liver surface 43 lesions were detected, whereas with the ICG-F 52 lesion of the liver surface were identified, including two superficial colorectal metastases missed at the intra-operative ultrasonography.
The ICG-F is a promising navigational tool, that can potentially overcome the limitations of the minimally invasive liver surgery.
吲哚菁绿（ICG）的荧光特性使其成为肝脏外科医生的有用技术手段，通过提供实时肝脏图谱来增强解剖结构的可视化。
我们分析了 2014 年 6 月至 2017 年 11 月期间，40 例连续接受机器人辅助肝切除术治疗恶性肿瘤的患者中 ICG 荧光染色技术的影响。
55%的患者的手术指征是结直肠癌肝转移，其次是 35%的肝癌。RO 切除率为 100%，平均切除边缘为 12mm。20%的患者出现肿瘤复发。1 年和 2 年总生存率分别为 91%和 84%。1 年和 2 年无病生存率分别为 77.2%和 65%。在 40 例患者中有 12 例，先前标记的手术线在染色方法后发生了改变。通过术中超声和肝脏表面白光探查，共检测到 43 个病变，而 ICG-F 发现肝脏表面有 52 个病变，包括术中超声漏诊的两个浅表结直肠转移灶。
ICG-F 是一种很有前途的导航工具，有可能克服微创肝手术的局限性。
