Patel Ishaan, Rehman Saad, McKay Siobhan, Bartlett David, Mirza Darius
Liver Unit, Queen Elizabeth Hospital, Third Floor Nuffield House, Mindelsohn Way, Birmingham B15 2TH, UK.
Royal North Shore Hospital, Reserve Road, St Leonards, Sydney, NSW 2065, Australia.
J Clin Med. 2023 Aug 25;12(17):5536. doi: 10.3390/jcm12175536.
Colorectal liver metastases (CRLM) afflict a significant proportion of patients with colorectal cancer (CRC), ranging from 25% to 30% of patients throughout the course of the disease. In recent years, there has been a surge of interest in the application of near-infrared fluorescence (NIRF) imaging as an intraoperative imaging technique for liver surgery. The utilisation of NIRF-guided liver surgery, facilitated by the administration of fluorescent dye indocyanine green (ICG), has gained traction in numerous medical institutions worldwide. This innovative approach aims to enhance lesion differentiation and provide valuable guidance for surgical margins. The use of ICG, particularly in minimally invasive surgery, has the potential to improve lesion detection rates, increase the likelihood of achieving R0 resection, and enable anatomically guided resections. However, it is important to acknowledge the limitations of ICG, such as its low specificity. Consequently, there has been a growing demand for the development of tumour-specific fluorescent probes and the advancement of camera systems, which are expected to address these concerns and further refine the accuracy and reliability of intraoperative fluorescence imaging in liver surgery. While NIRF imaging has been extensively studied in patients with CRLM, it is worth noting that a significant proportion of published research has predominantly focused on the detection of hepatocellular carcinoma (HCC). In this study, we present a comprehensive literature review of the existing literature pertaining to intraoperative fluorescence imaging in minimally invasive surgery for CRLM. Moreover, our analysis places specific emphasis on the techniques employed in liver resection using ICG, with a focus on tumour detection in minimal invasive surgery (MIS). Additionally, we delve into recent developments in this field and offer insights into future perspectives for further advancements.
结直肠癌肝转移（CRLM）影响着相当一部分结直肠癌（CRC）患者，在疾病全过程中，这一比例为25%至30%。近年来，作为肝脏手术的术中成像技术，近红外荧光（NIRF）成像的应用引发了广泛关注。通过注射荧光染料吲哚菁绿（ICG）实现的NIRF引导肝脏手术，在全球众多医疗机构中受到青睐。这种创新方法旨在增强病变鉴别能力，并为手术切缘提供有价值的指导。ICG的使用，尤其是在微创手术中，有可能提高病变检测率，增加实现R0切除的可能性，并实现解剖学引导下的切除。然而，必须认识到ICG的局限性，比如其特异性较低。因此，对肿瘤特异性荧光探针的开发以及相机系统的改进的需求日益增长，有望解决这些问题，并进一步提高肝脏手术中术中荧光成像的准确性和可靠性。虽然NIRF成像在CRLM患者中已得到广泛研究，但值得注意的是，大量已发表的研究主要集中在肝细胞癌（HCC）的检测上。在本研究中，我们对现有的关于CRLM微创手术中术中荧光成像的文献进行了全面的文献综述。此外，我们的分析特别强调了使用ICG进行肝切除的技术，重点是微创手术（MIS）中的肿瘤检测。此外，我们深入探讨了该领域的最新进展，并对未来进一步发展的前景提供了见解。
