数字三维重建技术联合吲哚菁绿（ICG）排泄试验在原发性肝癌精准肝切除中的应用效果
Effect of digital three-dimensional reconstruction technique combined with indocyanine green (ICG) excretion test for precision hepatectomy in primary liver cancer.
作者信息
Ye Rongqiang, Xie Yuancai, Zhong Dingwen, Lai Penghua, Zhang Lei
机构信息
Department of Hepatobiliary and Pancreatic Surgery, Ganzhou People's Hospital Ganzhou, Jiangxi, China.
Department of General Surgery, The First People's Hospital of Longnan Longnan, Jiangxi, China.
出版信息
Am J Transl Res. 2023 May 15;15(5):3511-3520. eCollection 2023.
OBJECTIVE
The aim of this study was to evaluate the residual volume of liver reserve function in liver cancer patients using three-dimensional reconstruction technique (3D technology) and the indocyanine green (ICG) excretion test.
METHODS
A retrospective analysis was conducted, and data were collected from 90 liver cancer patients in Ganzhou People's Hospital between January 2017 and December 2021. The control group underwent preoperative resectability evaluation based on traditional two-dimensional images, whereas the experimental group underwent digital three-dimensional reconstruction technique combined with indocyanine green (ICG) excretion test. The intraoperative bleeding volume, accuracy of preoperative surgical planning, operation time, postoperative complication rate, and perioperative mortality were compared between the two groups.
RESULTS
The assessment of resected liver volume (resectability) in the experimental group was larger than in the control group (P=0.003). Moreover, the accuracy rate of preoperative surgical planning in the experimental group was higher than in the control group (P=0.014). The intraoperative estimated blood loss favored the experimental group by a mean of 355 ml (P=0.02). Operative time and hospital stay favored the experimental group by a mean time of 204 min (P=0.03). The positive rate of liver resection margin and recurrence rate in the experimental group were lower than in the control group (P=0.021, P=0.004). Moreover, the two groups differed after intervention in terms of AST (P=0.001), ALT (P=0.0001), TBIL (P=0.001), and ALB (P=0.026).
CONCLUSION
The combination of three-dimensional reconstruction technique and indocyanine green (ICG) excretion test provides accurate visualization of hepatic anatomy and improves the precision of liver resection surgery, which is of great guiding value. This can optimize the preoperative evaluation and surgical planning for liver resection, shorten the operation time, and reduce intraoperative bleeding volume.
目的
本研究旨在利用三维重建技术（3D技术）和吲哚菁绿（ICG）排泄试验评估肝癌患者肝脏储备功能的残余量。
方法
进行回顾性分析，收集2017年1月至2021年12月期间赣州市人民医院90例肝癌患者的数据。对照组基于传统二维图像进行术前可切除性评估，而实验组采用数字三维重建技术结合吲哚菁绿（ICG）排泄试验。比较两组的术中出血量、术前手术规划的准确性、手术时间、术后并发症发生率和围手术期死亡率。
结果
实验组切除肝脏体积（可切除性）的评估大于对照组（P = 0.003）。此外，实验组术前手术规划的准确率高于对照组（P = 0.014）。术中估计失血量有利于实验组，平均为355毫升（P = 0.02）。手术时间和住院时间有利于实验组，平均时间为204分钟（P = 0.03）。实验组肝切除切缘阳性率和复发率低于对照组（P = 0.021，P = 0.004）。此外，两组在干预后AST（P = 0.001）、ALT（P = 0.0001）、TBIL（P = 0.001）和ALB（P = 0.026）方面存在差异。
结论
三维重建技术与吲哚菁绿（ICG）排泄试验相结合可提供肝脏解剖结构的精确可视化，并提高肝切除手术的精度，具有重要的指导价值。这可以优化肝切除的术前评估和手术规划，缩短手术时间并减少术中出血量。
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