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吲哚菁绿荧光技术在腹腔镜胃癌根治术中的临床应用

Clinical Application of Indocyanine Green Fluorescence Technology in Laparoscopic Radical Gastrectomy.

作者信息

Wei Meng, Liang Yize, Wang Limei, Li Zhen, Chen Yuanyuan, Yan Zhibo, Sun Danping, Huang Yadi, Zhong Xin, Liu Peng, Yu Wenbin

机构信息

Department of Gastrointestinal Surgery, General Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

Department of Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

出版信息

Front Oncol. 2022 Mar 4;12:847341. doi: 10.3389/fonc.2022.847341. eCollection 2022.

Abstract

BACKGROUND

This study aimed to observe the application and evaluate the feasibility and safety of indocyanine green (ICG) fluorescence technology in laparoscopic radical gastrectomy (LRG).

METHODS

Patients who underwent LRG & D2 lymphadenectomy at Qilu Hospital of Shandong University were included between January 2018 and August 2019. According to whether endoscopic injection of ICG was performed, patients were assigned to the ICG group (n=107) and the control group (n=88). The clinicopathologic features, retrieved lymph nodes, postoperative recovery, and follow-up data were compared between the two groups.

RESULTS

Baseline characteristics are comparable. The ICG group had a significantly larger number of lymph nodes retrieved (49.55 ± 12.72 vs. 44.44 ± 10.20, P<0.05), shorter total operation time (min) (198.22 ± 13.14 vs. 202.50 ± 9.91, P<0.05), shorter dissection time (min) (90.90 ± 5.34 vs. 93.74 ± 5.35, P<0.05) and less blood loss (ml) (27.51 ± 12.83 vs. 32.02 ± 17.99, P<0.05). The median follow-up time was 29.0 months (range 1.5-43.8 months), and there was no significant difference between the ICG group and the control group in 2-year OS (87.8% vs. 82.9%, P>0.05) or DFS (86.0% vs. 80.7%, P>0.05).

CONCLUSIONS

ICG fluorescence technology in laparoscopic radical gastrectomy has advantages in LN dissection, operation time, and intraoperative blood loss. The 2-year OS and 2-year DFS rates between the two groups were comparable. In conclusion, ICG fluorescence technology is feasible and safe.

摘要

背景

本研究旨在观察吲哚菁绿(ICG)荧光技术在腹腔镜根治性胃切除术(LRG)中的应用,并评估其可行性和安全性。

方法

选取2018年1月至2019年8月在山东大学齐鲁医院接受LRG及D2淋巴结清扫术的患者。根据是否进行内镜下ICG注射,将患者分为ICG组(n = 107)和对照组(n = 88)。比较两组患者的临床病理特征、获取的淋巴结数量、术后恢复情况及随访数据。

结果

基线特征具有可比性。ICG组获取的淋巴结数量显著更多(49.55 ± 12.72 vs. 44.44 ± 10.20,P < 0.05),总手术时间(分钟)更短(198.22 ± 13.14 vs. 202.50 ± 9.91,P < 0.05),解剖时间(分钟)更短(90.90 ± 5.34 vs. 93.74 ± 5.35,P < 0.05),失血量(毫升)更少(27.51 ± 12.83 vs. 32.02 ± 17.99,P < 0.05)。中位随访时间为29.0个月(范围1.5 - 43.8个月),ICG组和对照组在2年总生存率(87.8% vs. 82.9%,P > 0.05)或无病生存率(86.0% vs. 80.7%,P > 0.05)方面无显著差异。

结论

ICG荧光技术在腹腔镜根治性胃切除术中在淋巴结清扫、手术时间和术中失血量方面具有优势。两组之间的2年总生存率和2年无病生存率相当。总之,ICG荧光技术是可行且安全的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b6f/8931591/1f6eb0f687b8/fonc-12-847341-g001.jpg

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