荧光导航下腹腔镜结直肠癌腹主动脉旁淋巴结清扫新技术
New Technique of Laparoscopic Paraaortic Lymph Node Dissection for Colorectal Cancer Using Fluorescence Navigation.
作者信息
Ryu Shunjin, Hara Keigo, Goto Keisuke, Okamoto Atsuko, Kitagawa Takahiro, Marukuchi Rui, Ito Ryusuke, Nakabayashi Yukio
机构信息
Department of Digestive Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Japan.
出版信息
Cancer Diagn Progn. 2021 Jul 3;1(4):317-322. doi: 10.21873/cdp.10042. eCollection 2021 Sep-Oct.
BACKGROUND/AIM: According to limited current reports, therapeutic paraaortic lymph node (PALN) dissection with intensive combined therapy for colorectal cancer improves prognosis in select patients. Laparoscopic PALN dissection is a difficult technique that has not yet been established. We applied this procedure using an intraoperative fluorescence navigation technique with a near-infrared ray catheter (NIRC™) fluorescent ureteral catheter (NIRFUC).
PATIENTS AND METHODS
We evaluated the utility of laparoscopic fluorescence navigation and the short-term outcomes of 6 patients undergoing laparoscopic PALN dissection.
RESULTS
There were 3 surgeries for synchronous metastasis and 3 surgeries for recurrent metastasis. The mean surgical duration, blood loss, and postoperative hospital stay were 677 (range=518-1,090) min, 7.5 (range=3-1,600) ml, and 14 (range=9-33) days, respectively. Postoperative complications (Clavien-Dindo grade >III) occurred in 1 case.
CONCLUSION
Dissection around the ureter was navigated with a NIRFUC. Fluorescence ureteral navigation facilitated completion of the complex laparoscopic PALN dissection procedure.
背景/目的：根据目前有限的报道，对结直肠癌采用强化联合治疗并进行治疗性腹主动脉旁淋巴结（PALN）清扫可改善部分患者的预后。腹腔镜PALN清扫是一项尚未成熟的困难技术。我们应用术中荧光导航技术及近红外线导管（NIRC™）荧光输尿管导管（NIRFUC）实施了该手术。
患者与方法
我们评估了腹腔镜荧光导航的实用性以及6例行腹腔镜PALN清扫患者的短期结局。
结果
3例为同步转移手术，3例为复发转移手术。平均手术时间、失血量及术后住院时间分别为677（范围=518 - 1090）分钟、7.5（范围=3 - 1600）毫升和14（范围=9 - 33）天。术后并发症（Clavien-Dindo分级>Ⅲ级）发生1例。
结论
使用NIRFUC对输尿管周围进行清扫。荧光输尿管导航有助于完成复杂的腹腔镜PALN清扫手术。
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