Indocyanine green fluorescence-navigated laparoscopic metastasectomy for peritoneal metastasis of hepatocellular carcinoma: a case report.
Indocyanine green fluorescence-navigated laparoscopic metastasectomy for peritoneal metastasis of hepatocellular carcinoma: a case report.
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吲哚氨酸绿色荧光 - 纳瓦腹腔镜转移切除术，用于肝细胞癌的腹膜转移：病例报告。
DOI：
10.1186/s40792-018-0537-x
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发表时间：
2018-11-07
影响因子：
0.8
通讯作者：
Ohkohchi N
中科院分区：
文献类型：
--
作者：
Miyazaki Y;Kurata M;Oshiro Y;Shimomura O;Takahashi K;Oda T;Ohkohchi N
吲哚菁绿色（ICG）可选择性地在原发性肝细胞癌（HCC）及其肝外转移灶中蓄积。ICG荧光成像是检测HCC病灶的一种非常敏感的术中工具，可用于检测腹腔镜手术中无法触及的肿瘤。在这里，我们报告了一例75岁的男性患者，他接受了腹腔镜近红外成像系统和ICG荧光导航手术切除HCC腹膜转移瘤。一位75岁的男性被转介到我们的部门腹膜转移切除肝癌。入院前2年，他接受了经动脉栓塞和第6节段切除术，并接受了开放手术治疗破裂的HCC。计算机断层扫描显示在靠近肝脏切面的腹壁上有一个12 mm的腹膜转移灶。未观察到其他转移;计划切除孤立性转移瘤。术前72 h静脉注射ICG（0.5 mg/kg体重）。内窥镜下，ICG近红外荧光成像系统显示清晰的绿色荧光，表明腹壁上的HCC腹膜转移。手术切除肿瘤，切除部分肝脏和膈肌，切除足够的手术边缘，然后组织学证实为腹膜转移的肝癌。随访12个月，无复发。ICG荧光可以在腹腔镜手术中用于识别腹膜转移。
Indocyanine green (ICG) can selectively accumulate in primary hepatocellular carcinoma (HCC) and its extrahepatic metastases. ICG fluorescence imaging is an extremely sensitive intraoperative tool for detecting HCC foci and can be used to detect impalpable tumors in laparoscopic surgery. Here, we report a case of a 75-year-old man who underwent peritoneal metastasis resection of HCC using a laparoscopic near-infrared imaging system and ICG fluorescence-navigated surgery. A 75-year-old man was referred to our department for peritoneal metastasis resection of HCC. Two years before admission, he had undergone transarterial embolization and segmentectomy of segment 6 with open surgery for ruptured HCC. Computed tomography revealed a 12-mm peritoneal metastatic lesion on the abdominal wall near the cut surface of the liver. No other metastases were observed; resection of the solitary metastasis was scheduled. ICG (0.5 mg/kg body weight) was intravenously injected, 72 h preoperatively. An endoscopic, ICG near-infrared fluorescence imaging system revealed clear green fluorescence, indicating peritoneal metastasis of HCC on the abdominal wall. The tumor was resected with adequate surgical margin by partially resecting the liver and diaphragm, followed by histological confirmation as peritoneal metastasis of HCC. No recurrence was observed after 12 months of follow-up. ICG fluorescence can be useful in laparoscopic surgery for identifying peritoneal metastasis.