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吲哚菁绿荧光血管造影术在腹腔镜袖状胃切除术中的应用:初步结果。

Application of indocyanine green fluorescence angiography in laparoscopic sleeve gastrectomy: preliminary results.

作者信息

Wei Rongwei, Li Yonglin, Zheng Qi, Wang Jing, Wu Chengyu, Lu Xiaojing, Zong Ziliang, Chen Yigang

机构信息

Jiangnan University, Wuxi, Jiangsu, China.

Department of General Surgery, Wuxi No. 2 People's Hospital, Jiangnan University Medical Center, Wuxi, Jiangsu, China.

出版信息

Langenbecks Arch Surg. 2025 Jul 3;410(1):213. doi: 10.1007/s00423-025-03792-8.

Abstract

BACKGROUND

In recent years, as researchers have discovered that indocyanine green (ICG) near-infrared fluorescence imaging offers excellent tissue penetration, the application of ICG fluorescence angiography (ICG-FA) in various laparoscopic procedures has become increasingly widespread and gets significant therapeutic efficacy. However, its use in laparoscopic sleeve gastrectomy (LSG) has not been extensively reported.

MATERIALS AND METHODS

A retrospective study was conducted on the clinical data of 291 patients who underwent LSG at our clinical medical center between September 2021 and November 2024. The patients were divided into two groups: Group A, consisting of 195 cases (without intraoperative use of ICG-FA), and Group B, comprising 96 cases (with intraoperative use of ICG-FA). Statistical software was utilized for data processing and analysis.

RESULTS

The mean blood loss along the staple line was 6.53 ± 1.69 mL in Group A and 2.57 ± 1.81 mL in Group B (p < 0.001). The mean operative time was 99.01 ± 22.63 min in Group A and 94.04 ± 22.88 min in Group B (p < 0.05). The mean hospital stay was 5.89 ± 1.48 days in Group A and 4.95 ± 2.92 days in Group B (p < 0.001). Among all 291 patients, there were 2 cases of gastric leakage, with 1 case occurring in each group, 4 patients experienced postoperative bleeding, with 2 cases occurring in each group.

CONCLUSIONS

Findings from our institutional data indicate that while ICG-FA demonstrated statistically significant reductions in staple line bleeding (due to suture needle punctures), shorter mean operative time, and decreased average hospital stay, its clinical benefits in LSG for morbid obesity appear limited compared to its established utility in other laparoscopic procedures. Furthermore, ICG-FA did not reduce the incidence of postoperative complications, such as gastric leaks or bleeding.

摘要

背景

近年来,随着研究人员发现吲哚菁绿(ICG)近红外荧光成像具有出色的组织穿透性,ICG荧光血管造影术(ICG-FA)在各种腹腔镜手术中的应用越来越广泛,并取得了显著的治疗效果。然而,其在腹腔镜袖状胃切除术(LSG)中的应用尚未得到广泛报道。

材料与方法

对2021年9月至2024年11月期间在我院临床医学中心接受LSG的291例患者的临床资料进行回顾性研究。患者分为两组:A组195例(术中未使用ICG-FA),B组96例(术中使用ICG-FA)。使用统计软件进行数据处理和分析。

结果

A组吻合口平均出血量为6.53±1.69 mL,B组为2.57±1.81 mL(p<0.001)。A组平均手术时间为99.01±22.63分钟,B组为94.04±22.88分钟(p<0.05)。A组平均住院时间为5.89±1.48天,B组为4.95±2.92天(p<0.001)。在所有291例患者中,有2例发生胃漏,每组各1例;4例患者术后出血,每组各2例。

结论

我们机构的数据结果表明,虽然ICG-FA在吻合口出血(由于缝合针刺破)方面显示出统计学上的显著减少、平均手术时间缩短和平均住院时间减少,但其在病态肥胖的LSG中的临床益处与在其他腹腔镜手术中的既定效用相比似乎有限。此外,ICG-FA并未降低术后并发症(如胃漏或出血)的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa28/12226696/02add30c1ff6/423_2025_3792_Fig1_HTML.jpg

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