摘要
目的探讨吲哚菁绿(indocyanine green, ICG)荧光显像技术在腹腔镜肝切除术中的安全性和有效性。方法回顾性分析福建医科大学孟超肝胆医院2018年1月至2019年12月行腹腔镜肝切除术病人的临床资料。采用倾向性评分匹配和Kaplan-Meier生存分析,比较匹配前后两组病人的术中指标(手术时间、出血量、输液量、输血率和切缘情况),术后指标(并发症和住院时间)和预后指标。结果共纳入145例病人,行常规腹腔镜肝切除病人114例(对照组),ICG荧光显像技术引导下腹腔镜肝切除病人31例(研究组)。经1∶1倾向性评分匹配后,两组均有31例病人纳入分析,临床基本特征差异无统计学意义(P>0.05)。匹配后研究组的术中出血量、术中输液量、术后住院时间均显著少于对照组(P<0.05);研究组宽切缘比率多于对照组(P<0.05);两组手术时间、术中输血率、R0切除率、术后并发症和无瘤生存率等差异均无统计学意义(均P>0.05)。结论 ICG荧光显像引导腹腔镜肝切除是一种安全有效的技术,可以获得更好的围手术期收益。
Objective To explore the safety and effectiveness of indocyanine green(ICG)fluorescent imaging technique during laparoscopic hepatectomy.Methods From January 2018 to December 2019,clinical data of 145 patients undergoing laparoscopic hepatectomy were retrospectively reviewed.Intraoperative parameters(operative duration,blood loss,infusion volume,blood transfusion&resection margin),postoperative indicators(complications&hospitalization stay)and prognoses of two groups were compared by propensity score matching(PSM)and Kaplan-Meier survival analysis.Results The procedures were conventional laparoscopic liver resection(control group,n=114)and ICG fluorescent imaging guided laparoscopic hepatectomy(study group,n=31).After 1∶1 PSM,31 patients in both groups were included for analysis and no statistical difference existed in basic clinical characteristics(P>0.05).After PSM,intraoperative blood loss,fluid infusion and postoperative hospitalization stay were significantly less in study group than those in control group(P<0.05);the ratio of wide margins was more in study group than that in control group(P<0.05);no significant inter-group difference existed in operative duration,intraoperative blood transfusion rate,R0 resection rate,postoperative complications or disease free survival(DFS)(P>0.05).Conclusion Under the guidance of indocyanine green fluorescent imaging,laparoscopic hepatectomy is both safe and effective for optimizing perioperative benefits.
作者
辛富理
柯桥
刘红枝
韦族武
刘小龙
刘景丰
曾永毅
Xin Fuli;Ke Qiao;Liu Hongzhi;Wei Zuwu;Liu Xiaolong;Liu Jingfeng;Zeng Yongyi(Department of Hepatobiliary Surgery,Mengchao Hepatobiliary Hospital,Fujian Medical University,Fujian Fuzhou 350025,China)
出处
《腹部外科》
2021年第4期271-275,290,共6页
Journal of Abdominal Surgery
基金
福建省卫生教育联合攻关计划项目(2019-WJ-12)。
关键词
吲哚菁绿
腹腔镜肝切除术
肝细胞癌
Indocyanine green
Laparoscopic hepatectomy
Hepatocellular carcinoma
