Su Hao, Wu Hongliang, Bao Mandula, Luo Shou, Wang Xuewei, Zhao Chuanduo, Liu Qian, Wang Xishan, Zhou Zhixiang, Zhou Haitao
Department of Colorectal Surgery, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 17, Pan Jia Yuan Nan Li, Chaoyang District, Beijing, 100021, People's Republic of China.
Department of Anesthesiology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100021, China.
BMC Surg. 2020 May 13;20(1):102. doi: 10.1186/s12893-020-00745-4.
To retrospectively evaluate the feasibility and safety of intraoperative assessment of bowel perfusion in totally laparoscopic surgery for colon cancer using indocyanine green fluorescence imaging (IGFI).
From October 2017 to June 2019, consecutive patients with colon cancer who underwent totally laparoscopic surgery were enrolled retrospectively and grouped into the IGFI group (n = 84) and control group (n = 105). In the IGFI group, indocyanine green (ICG) was injected intravenously, and the bowel perfusion was observed using a fluorescence camera system prior to and after completion of the anastomosis.
The two groups were demographically comparable. The IGFI group exhibited a significantly shorter operative time (p = 0.0374) while intraoperative blood loss did not significantly differ among the groups (p = 0.062). In the IGFI group, average time to perfusion fluorescence was 48.4 ± 14.0 s after ICG injection, and four patients (4.8%) were required to choose a more proximal point of resection due to the lack of adequate fluorescence at the point previously selected. There were no differences in terms of pathological outcomes, postoperative recovery and the postoperative complication rates between the groups (p>0.05).
IGFI shows promise as a safe and feasible tool to assess bowel perfusion during a totally laparoscopic surgery for colon cancer and may reduce the operative time.
回顾性评估在完全腹腔镜结肠癌手术中使用吲哚菁绿荧光成像（IGFI）进行术中肠灌注评估的可行性和安全性。
回顾性纳入2017年10月至2019年6月期间连续接受完全腹腔镜手术的结肠癌患者，分为IGFI组（n = 84）和对照组（n = 105）。IGFI组静脉注射吲哚菁绿（ICG），在吻合完成前后使用荧光摄像系统观察肠灌注情况。
两组在人口统计学上具有可比性。IGFI组手术时间显著缩短（p = 0.0374），而术中出血量在两组间无显著差异（p = 0.062）。在IGFI组中，注射ICG后平均灌注荧光时间为48.4 ± 14.0秒，4例患者（4.8%）因先前选择的部位荧光不足而需要选择更近端的切除点。两组在病理结果、术后恢复和术后并发症发生率方面无差异（p>0.05）。
IGFI有望成为完全腹腔镜结肠癌手术中评估肠灌注的安全可行工具，并可能缩短手术时间。
