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吲哚菁绿荧光成像定位辅助胸腔镜修复术治疗食管闭锁术后再发狭窄

Indocyanine green fluorescence imaging localization-assisted thoracoscopy revision surgery after repair of esophageal atresia.

机构信息

Department of Neonatal Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.

出版信息

BMC Gastroenterol. 2022 Aug 5;22(1):373. doi: 10.1186/s12876-022-02444-1.

Abstract

Revision surgery for the complications after repair of esophageal atresia is often complex because of previous surgeries and chest infections and thus requires surgical expertise. This study describes surgical experiences with the use of indocyanine green (ICG) fluorescence imaging localization-assisted thoracoscopy during revision surgery, including recurrent tracheoesophageal fistula (rTEF) (8 cases, one of which was esophageal-pulmonary fistula) and delayed esophageal closure (1 case). We performed fistula repair and esophageal reconstruction according to the indications of ICG. The application of this method avoids the excessive trauma caused by freeing the trachea and esophagus. Contrast imaging taken one week and one month after surgery indicated no spillover of the contrast agent from the esophagus, except in 1 case. Indocyanine green fluorescence imaging localization-assisted thoracoscopy is worth promoting for revision surgery after esophageal atresia repair.

摘要

修复食管闭锁术后并发症的再次手术通常较为复杂,因为有先前的手术和胸部感染,因此需要手术专业知识。本研究描述了使用吲哚菁绿(ICG)荧光成像定位辅助胸腔镜进行再次手术的经验,包括复发性气管食管瘘(rTEF)(8 例,其中 1 例为食管-肺瘘)和食管闭合延迟(1 例)。我们根据 ICG 的指征进行瘘修补和食管重建。该方法的应用避免了因游离气管和食管而造成的过度创伤。术后一周和一个月的对比成像显示,除 1 例外,造影剂均未从食管溢出。吲哚菁绿荧光成像定位辅助胸腔镜在食管闭锁修复后的再次手术中值得推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1896/9354272/cad98b0c59d5/12876_2022_2444_Fig1_HTML.jpg

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