摘要
目的探讨腹腔镜肝切除术中联合应用吲哚菁绿(indocyanine green,ICG)荧光显像技术打开“肝脏四扇门”的手术方式治疗肝细胞癌的安全性和有效性。方法回顾性分析四川大学华西医院肝脏外科2017年4月到2019年10月期间收治的103例行腹腔镜肝切除术病人的临床资料,包括研究组(联合ICG荧光显像技术打开“肝脏四扇门”的腹腔镜肝切除病人)38例,对照组(常规腹腔镜肝切除病人)65例。比较两组病人的术前基线资料、手术时间、术中出血量、术后住院时间、术后并发症发生率和预后信息等,分析联合ICG荧光显像技术打开“肝脏四扇门”的腹腔镜精准肝切除术的疗效。结果共103例符合纳入标准的病人完成全腹腔镜肝切除术。与对照组相比,研究组病人的手术时间更短[(214.55±75.28)min比(251.74±91.57)min,P<0.05],术中出血量更少[(167.63±159.72)ml比(251.08±213.34)ml,P<0.05],术后住院时间更短[(4.45±1.52)d比(5.92±2.59)d,P<0.05],而其他指标两组差异无统计学意义,包括手术方式,术后并发症发生率,术后1年、2年总生存率和1年、2年无瘤生存率等。结论联合ICG荧光显像技术打开“肝脏四扇门”的腹腔镜精准肝切除术具有更好的围手术期收益,其安全性和有效性值得肯定,但仍需要更多病例和更长随访时间进一步论证该技术对病人远期生存的影响。
Objective To investigate the safety and efficacy of laparoscopic hepatectomy combined with indocyanine green(ICG)fluorescence imaging technique to open the"four doors of the liver"in the treatment of hepatocellular carcinoma.Methods The clinical data of 103 patients who underwent laparoscopic hepatectomy from April 2017 to October 2019 in the Department of Liver Surgery,West China Hospital,Sichuan University were retrospectively analyzed,including 38 patients in the study group(laparoscopic hepatectomy patients with"four doors of the liver"opened by ICG fluorescence imaging technique)and 65 patients in the control group(conventional laparoscopic hepatectomy patients).The preoperative baseline data,operation time,intraoperative blood loss,postoperative hospital stay,incidence rate of postoperative complications and prognosis information were compared between the two groups,and the efficacy of laparoscopic precise hepatectomy combined with ICG fluorescence imaging technique to open"four doors of the liver"was analyzed.Results A total of 103 patients who met the inclusion criterias underwent completed laparoscopic hepatectomy.The results were as follows:Compared with the control group,the study group had shorter operation time[(214.55±75.28)min vs.(251.74±91.57)min,P<0.05],less intraoperative blood loss[(167.63±159.72)ml vs.(251.08±213.34)ml P<0.05]and shorter postoperative hospital stays[(4.45±1.52)d vs.(5.92±2.59)d,P<0.05],while there were no statistically significant difference in other indicators,including surgical methods,complication rate,1-and 2-year overall survival rates,1-and 2-year disease-free survival rates etc.Conclusion Laparoscopic precise hepatectomy combined with ICG fluorescence imaging technology to open the"Four Hepatic Doors"has better perioperative benefits with highly proved safety and effectiveness.However,future research needs to further demonstrate the impact of this technology on the long-term survival of patients based on more cases and longer follow-up time.
作者
谢国伟
吴泓
Xie Guowei;Wu Hong(Department of Liver Surgery, West China Hospital, Sichuan University, Sichuan Chengdu 610041, China)
出处
《腹部外科》
2020年第3期184-189,共6页
Journal of Abdominal Surgery
关键词
腹腔镜
吲哚菁绿
肝脏四扇门
精准肝切除
肝细胞癌
Laparoscopic
Indocyanine green
Four Hepatic Doors
Precise hepatectomy
Hepatocellular carcinoma
