Yao Shunyu, Zhang Luyuan, Ma Jinliang, Jia Weidong, Chen Hao
Department of Hepatic Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, HeFei, 230001, China.
Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, HeFei, 230001, China.
J Cancer. 2020 Feb 10;11(9):2465-2475. doi: 10.7150/jca.41039. eCollection 2020.
To evaluate the clinical significance of fusion indocyanine green (ICG) fluorescence imaging in precise right hemihepatectomy for the treatment of hepatocellular carcinoma (HCC). 47 patients with HCC who underwent right hemihepatectomy were retrospectively analyzed. 18 of them guided by fusion ICG fluorescence imaging (FIGFI) while 29 patients underwent conventional right hepatectomy without guidance. Compared to the patients with conventional treatment, the intraoperative blood loss of the patients with guided surgery was significantly less, and no transfusion and hepatic occlusion were performed during the operation. Liver function recovery faster in guided group. The incidence of postoperative complications is also lower, and the recurrence rate in one year is significantly reduced. ICG fluorescence range of 18 patients in liver surface was consistent with the ischemic line, and their postoperative liver cross-sections were clearly demarcation. There were no significant differences in the mean operation time, blood loss, postoperative hospital stays, cases of blood transfusion, complication rate, or postoperative peak volume of ALT and TB between positive or negative staining groups. Pathology results of all patients demonstrated HCC and negative margins, and microvascular invasion occurred in 8 cases. The average follow-up time of 18 patients was 16.7 months, and recurrence was found in 5 cases after surgery. FIGFI could guide the anatomical right hepatectomy with real -time increased radical rate, accuracy and safety for the treatment of HCC, and therefore showed a promising prospect.
评估融合吲哚菁绿（ICG）荧光成像在精准右半肝切除治疗肝细胞癌（HCC）中的临床意义。回顾性分析47例行右半肝切除的HCC患者。其中18例采用融合ICG荧光成像引导（FIGFI），29例患者行传统右肝切除未行引导。与传统治疗患者相比，引导手术患者术中出血量明显减少，术中未输血及行肝门阻断。引导组肝功能恢复更快。术后并发症发生率也更低，一年复发率显著降低。18例患者肝脏表面ICG荧光范围与缺血线一致，术后肝脏断面分界清晰。阳性或阴性染色组之间平均手术时间、出血量、术后住院时间、输血例数、并发症发生率或术后ALT和TB峰值体积无显著差异。所有患者病理结果均显示为HCC且切缘阴性，8例发生微血管侵犯。18例患者平均随访时间为16.7个月，术后5例复发。FIGFI可引导解剖性右肝切除，提高HCC治疗的根治率、准确性和安全性，具有广阔的应用前景。
