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融合吲哚菁绿荧光成像在全腹腔镜右半结肠癌根治术中的临床应用

[Clinical application of fusion indocyanine green fluorescence imaging in total laparoscopic radical resection for right colon cancer].

作者信息

Su H, Bao M D L, Wang P, Wang X W, Zhao C D, Liang J W, Liu Q, Wang X S, Zhou Z X, Zhou H T

机构信息

Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2019 Sep 23;41(9):654-658. doi: 10.3760/cma.j.issn.0253-3766.2019.09.003.

Abstract

This study aims to explore the clinical value of fusion indocyanine green fluorescence imaging (FIGFI) in total laparoscopic radical resection for right colon cancer. From October, 2018 to December, 2018, 15 patients who underwent total laparoscopic radical resection for right colon cancer using FIGFI in Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College were retrospectively enrolled in this study. Data regarding surgical outcomes, postoperative recovery, pathological outcomes and complications were collected and analyzed. All patients successfully underwent total laparoscopic radical resection for right colon cancer using FIGFI. 1 patients (6.7%) received extended resection of bowel due to poor blood supply after mesentery excision. The average operation time was 133.7 minutes and intraoperative blood loss was 26.7 ml. The average time to ground activities, fluid diet intake, first flatus and postoperative hospitalization were 19.1 h, 11.7 h, 32.5 h and 5.0 d, respectively. The average length of tumor was 4.5 cm. The average proximal and distal resection margins were 14.9 cm and 12.1 cm, respectively. The average number of lymph nodes retrieved was 29.3 per patient. Only one patient suffered from incisional fat liquefaction after surgery and was managed effectively by regular dressing change. No severe complications such as indocyanine green allergy, anastomotic stenosis, anastomotic leakage, abdominal bleeding, bowel obstruction, pulmonary infection, and abdominal infection occurred in any patients. FIGFI is helpful to judge the blood supply of intestinal segments and anastomotic stoma in total laparoscopic radical resection for right colon cancer quickly. It is a safe and feasible technique with satisfactory short-term effect.

摘要

本研究旨在探讨融合吲哚菁绿荧光成像(FIGFI)在右半结肠癌全腹腔镜根治性切除术中的临床价值。回顾性纳入2018年10月至2018年12月在中国医学科学院肿瘤医院、北京协和医学院使用FIGFI行右半结肠癌全腹腔镜根治性切除术的15例患者。收集并分析手术结果、术后恢复情况、病理结果及并发症等数据。所有患者均成功使用FIGFI行右半结肠癌全腹腔镜根治性切除术。1例患者(6.7%)因肠系膜切除后血供不佳接受了肠扩大切除术。平均手术时间为133.7分钟,术中出血量为26.7毫升。下地活动、流食摄入、首次排气及术后住院的平均时间分别为19.1小时、11.7小时、32.5小时和5.0天。肿瘤平均长度为4.5厘米。近端和远端切缘平均分别为14.9厘米和12.1厘米。每位患者平均获取淋巴结数为29.3枚。仅1例患者术后出现切口脂肪液化,经定期换药有效处理。所有患者均未发生吲哚菁绿过敏、吻合口狭窄、吻合口漏、腹腔出血、肠梗阻、肺部感染及腹腔感染等严重并发症。FIGFI有助于在右半结肠癌全腹腔镜根治性切除术中快速判断肠段及吻合口的血供情况。它是一种安全可行的技术,短期效果良好。

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