吲哚菁绿荧光导航和三维可视化腹腔镜精准手术治疗原发性肝癌患者应用研究*

doi:10.3969/j.issn.1672-5069.2021.04.027

摘要/Abstract

摘要： 目的探讨应用吲哚菁绿荧光导航和三维可视化精准手术治疗原发性肝癌(PLC)患者的应用价值。方法 2015年1月～2019年12月我院收治的PLC患者114例,采用随机数字表法分为对照组57例和观察组57例,分别行吲哚菁绿荧光导航和腹腔镜下肝癌切除术或吲哚菁绿荧光导航和三维可视化腹腔镜下肝癌切除术。采用放射免疫法测定血清皮质醇(COR)水平,采用ELISA法测定血清白介素-6(IL-6)水平。结果观察组住院时间为(6.9±2.3)d,与对照组比较差异无统计学意义【(7.5±2.5)d,P>0.05】,两组荧光染色满意率分别为91.2%和91.2%(P>0.05),观察组手术时间和术中出血量分别为(181.0±59.6)min和(96.9±21.7)ml,显著短于或少于对照组分别为【(210.4±86.5)min和(106.3±25.0)ml,P<0.05】;两组手术前后肝功能指标比较,无显著性差异(P<0.05);术后,观察组血清COR和IL-6水平分别为(264.3±33.8)mmol/L和(108.0±13.8)pg/ml,显著低于对照组【(288.0±34.5)mmol/L和(116.1±15.8)pg/ml,P<0.05】;术后,两组胆漏、胸腹腔积液和发热等围术期并发症发生率(24.6%对36.8%)比较,差异无统计学意义(P>0.05)。结论采用吲哚菁绿荧光导航技术和三维可视化腹腔镜下肝癌精准切除术治疗PLC患者,有利于精准切除肿瘤,缩短手术时间,值得进一步研究。

关键词: 原发性肝癌, 吲哚菁绿荧光导航技术, 三维可视化, 腹腔镜肝癌切除术, 治疗

Abstract: Objective The aim of this study was to investigate the application of indocyanine green fluorescence navigation technology and three-dimensional visualization in laparoscopic precision surgery for patients with primary liver cancer (PLC). Methods A total of 114 patients with PLC were admitted to our hospital between January 2015 and December 2019, and were randomly divided into observation (n=57) and control group (n=57). The patients in the control received indocyanine green fluorescence navigation and laparoscopic hepatectomy and those in the combination received indocyanine green fluorescence navigation and laparoscopic hepatectomy under three-dimensional visualization. Serum cortisol (COR) and interleukin 6 (IL-6) were detected. Results The hospital stay were(6.9±2.3)d and (7.5±2.5)d (P>0.05) in the combination and control group, the satisfaction rates of fluorescent staining in the two groups were 91.2% and 91.2%(P>0.05), while the operation time and blood loss in the combination were (181.0±59.6)min and (96.9±21.7)ml, both significantly shorter or less than [(210.4±86.5)min and (106.3±25.0)ml, respectively,P<0.05] in the control; there was no significant differences as respect to the liver function tests between the two groups (P<0.05); after operation, serum COR and IL-6 levels in the combination were (264.3±33.8)mmol/L and (108.0±13.8)pg/ml, both significantly lower than [(288.0±34.5)mmol/L and (116.1±15.8)pg/ml, respectively, P<0.05] in the control; after operation, the incidences of bile leakage, pleural effusion and ascites, and fever in the two groups were 24.6% vs. 36.8%, without significant differences (P>0.05). Conclusion The application of indocyanine green fluorescence navigation technology and laparoscopic hepatectomy under three-dimensional visualization might help remove the tumors precisely and shorten operational times, which warrants more clinical observations.

Key words: Hepatoma, Three-dimensional visualization, Indocyanine green fluorescence navigation technology, Laparoscopic hepatectomy, Therapy

刘永昌, 赵殿堂, 孙启峰, 张启文. 吲哚菁绿荧光导航和三维可视化腹腔镜精准手术治疗原发性肝癌患者应用研究^*[J]. 实用肝脏病杂志, 2021, 24(4): 561-564.

Liu Yongchang, Zhao Diantang, Sun Qifeng, et al. Application of indocyanine green fluorescence navigationand three-dimensional visualization in laparoscopic precision surgery for patients with primary liver cancer[J]. Journal of Practical Hepatology, 2021, 24(4): 561-564.

参考文献

[1] Grandhi MS, Kim AK, Ronnekleiv-Kelly SM, et al. Hepatocellular carcinoma:from diagnosis to treatment. Surg Oncol, 2016, 25(2):74-85.
[2] Massarweh NN, El-Serag HB. Epidemiology ofhepatocellular carcinoma and intrahepatic cholangiocarcinoma. Cancer Control, 2017, 24(3):107-117.
[3] Luo F, Zhou J, Yan W. A comparative study of laparoscopic precise hepatectomy with conventional open hepatectomy in the treatment of primary hepatocellular cancer. J Buon, 2019, 24(5):1943-1949.
[4] Boogerd LS, Handgraaf HJ, Lam HD,et al. Laparoscopic detection and resection of occult liver tumors of multiple cancer types using real-time near-infrared fluorescence guidance. Surg Endosc, 2017, 31(2):952-961.
[5] Kokudo N, Takemura N, Ito K,et al. The history of liver surgery: achievements over the past 50 years. Ann Gastroenterol Surg, 2020, 4(2):109-117.
[6] Fang C, An J, Bruno A,et al. Consensus recommendations of three-dimensional visualization for diagnosis and management of liver diseases. Hepatol Int, 2020, 14(4):437-453.
[7] 中华人民共和国国家卫生和计划生育委员会. 原发性肝癌诊疗规范(2017年版). 中华肝脏病杂志, 2017, 25(12):886-895.
[8] Kaibori M, Kon M, Kitawaki T,et al. Comparison of anatomic and non-anatomic hepatic resection for hepatocellular carcinoma. J Hepatobiliary Pancreat Sci, 2017, 24(11):616-626.
[9] Kaibori M, Matsui K, Ishizaki M,et al. Evaluation of fluorescence imaging with indocyanine green in hepatocellular carcinoma. Cancer Imaging, 2016, 6(16):6.
[10] 王鹏飞, 陈明易, 卢实春, 等. 吲哚菁绿荧光引导腹腔镜解剖性肝脏Ⅶ段切除手术流程. 中华肝胆外科杂志, 2019, 25(2):137-139.
[11] 马家豪, 王连才, 王亚峰,等. 吲哚菁绿荧光融合影像技术在腹腔镜肝癌解剖性肝切除术中的应用. 中华普通外科杂志, 2019, 34(7)::586-589.
[12] 王晓颖, 高强, 朱晓东, 等. 腹腔镜超声联合三维可视化技术引导门静脉穿刺吲哚菁绿荧光染色在精准解剖性肝段切除术中的应用. 中华消化外科杂志, 2018, 17(5):452-458.
[13] Zhang B, Chen Z, Hu X,et al. Application of three-dimensional visualization technology in laparoscopic surgery for pheochromocytoma/paraganglioma: a single-center experience. J Laparoendosc Adv Surg Tech A, 2018, 28(8):997-1002.
[14] Fukutomi S, Nomura Y, Nakashima O,et al. Evaluation of hepatocellular carcinoma spread via the portal system by 3-dimensional mapping. HPB (Oxford), 2017, 19(12):1119-1125.
[15] Jang JY, Han HS, Yoon YS,et al. Three-dimensional laparoscopic anatomical segment 8 liver resection with glissonian approach. Ann Surg Oncol, 2017, 24(6):1606-1609.
[16] Mizuno T, Sheth R, Yamamoto M,et al. Laparoscopic glissonean pedicle transection (Takasaki) for negative fluorescent counterstaining of segment 6. Ann Surg Oncol, 2017, 24(4):1046-1047.
[17] Timaran Montenegro DE, Torres Ramirez CA, Mateo CYS,et al. CT-based hepatic residual volume and predictors of outcomes of patients with hepatocellular carcinoma unsuitable for surgical therapy undergoing transarterial chemoembolization. Acad Radiol, 2020, 27(6):807-814.
[18] Mizutani Y, Hirai T, Nagamachi S,et al. Prediction of posthepatectomy liver failure proposed by the international study group of liver surgery: residual liver function estimation with 99mTc-galactosyl human serum albumin scintigraphy. Clin Nucl Med, 2018,43(2):77-81.
[19] Guan TP, Fang CH, Yang J,et al. A comparison between three-dimensional visualization guided hepatectomy and ultrasonography guided radiofrequency ablation in the treatment of small hepatocellular carcinoma within the Milan criteria. Biomed Res Int, 2016, 20(16):893-901.
[20] 吴晓龙, 毕新宇, 李智宇, 等.术后中性粒细胞和淋巴细胞比值与肝细胞癌切除术后复发及患者生存的关系. 中华肿瘤杂志, 2018, 40(5):365-371.

吲哚菁绿荧光导航和三维可视化腹腔镜精准手术治疗原发性肝癌患者应用研究^*

Application of indocyanine green fluorescence navigationand three-dimensional visualization in laparoscopic precision surgery for patients with primary liver cancer

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	张佳, 晋明渊, 杜艳云, 胡秀娟, 王烈姣. NAFLD合并Hp感染患者清除治疗前后血清细胞因子水平变化^*[J]. 实用肝脏病杂志, 2021, 24(4): 500-503.
[2]	陈维, 魏涛, 杨岚, 伍小敏. 原发性肝癌患者癌组织NLRP3炎性小体表达状况研究[J]. 实用肝脏病杂志, 2021, 24(4): 544-547.
[3]	王雪梅, 张瑶, 杨学平, 王玥, 张记. 超声引导下经皮肝穿刺抽脓法和置管引流法治疗艾滋病并发肝脓肿患者临床效果分析[J]. 实用肝脏病杂志, 2021, 24(4): 573-576.
[4]	唐文涛, 黄会, 蔡婵娟. 平阳霉素联合超化碘油混悬液经动脉介入栓塞治疗肝血管瘤患者中远期疗效研究^*[J]. 实用肝脏病杂志, 2021, 24(4): 581-584.
[5]	史海军, 张日欣, 宁纯民. 规则性肝叶切除治疗复杂性肝内胆管结石患者疗效研究[J]. 实用肝脏病杂志, 2021, 24(4): 585-588.
[6]	付前广, 李倩, 冯小雪, 王勇, 邓如兵, 崔畅. 腹腔镜胆总管探查术联合腹腔镜胆囊切除术治疗胆囊结石合并胆总管结石患者临床疗效研究^*[J]. 实用肝脏病杂志, 2021, 24(4): 589-592.
[7]	王群先, 王云川, 陈有英. 肝脏部分切除术患者不同时机七氟烷吸入麻醉应用效果分析[J]. 实用肝脏病杂志, 2021, 24(4): 597-599.
[8]	安西全, 李燕, 孟根才次克. 替诺福韦联合索拉非尼治疗乙型肝炎相关中晚期原发性肝癌患者临床观察[J]. 实用肝脏病杂志, 2021, 24(4): 600-602.
[9]	毕再鸿, 韩白乙拉, 王炳元. 治疗慢性肝病的新药:辛伐他汀^*[J]. 实用肝脏病杂志, 2021, 24(4): 603-606.
[10]	袁平戈, 陈文雯. 非酒精性脂肪性肝炎新药研发临床思考[J]. 实用肝脏病杂志, 2021, 24(3): 305-307.
[11]	徐文婷, 张继红, 韦冬珏, 李巍. 替诺福韦补救治疗rtM204位点突变的慢性乙型肝炎患者效果研究[J]. 实用肝脏病杂志, 2021, 24(3): 335-338.
[12]	王雪, 瞿发林, 戚伟利, 钱薇. 慢性乙型肝炎患者外周血Treg/Th17比值平衡及其对替比夫定治疗效果的影响[J]. 实用肝脏病杂志, 2021, 24(3): 339-342.
[13]	陈熙, 王玮, 高健伟, 许乐. 合并非酒精性脂肪性肝病对恩替卡韦治疗慢性乙型肝炎患者抗病毒疗效的影响[J]. 实用肝脏病杂志, 2021, 24(3): 343-346.
[14]	裴旭东, 张晓虎, 褚桂克, 李延玲, 赵萍, 王立坤, 陈新菊. 消脂祛浊方治疗合并肥胖的痰湿型非酒精性单纯性脂肪肝患者临床效果初步研究[J]. 实用肝脏病杂志, 2021, 24(3): 355-358.
[15]	齐玫, 张瑞金, 田树萍, 于艳华. 平均血小板体积对自身免疫性肝炎患者治疗不应答的预测价值分析[J]. 实用肝脏病杂志, 2021, 24(3): 371-374.