Innovative marking method using novel endoscopic clip equipped with fluorescent resin to locate gastric cancer
Innovative marking method using novel endoscopic clip equipped with fluorescent resin to locate gastric cancer
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使用配备荧光树脂的新型内窥镜夹来定位胃癌的创新标记方法
DOI：
10.1111/ases.12842
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发表时间：
2021
影响因子：
1
通讯作者：
Hanazaki Kazuhiro
中科院分区：
文献类型：
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作者：
Namikawa Tsutomu;Hashiba Motoi;Kitagawa Hiroyuki;Mizuta Hiroshi;Uchida Kazushige;Sato Takayuki;Kobayashi Michiya;Hanazaki Kazuhiro
一位无症状的76岁男性因治疗胃癌而来我科就诊。食管胃十二指肠镜检查显示胃下1/3有浅表隆起，中央不规则凹陷，活检证实为腺癌，腹部增强CT未发现异常病变。根据患者早期胃癌的临床诊断，我们计划行腹腔镜胃切除术，术前放置4个配备吲哚青绿结合树脂的内窥镜标记夹以确定切除边缘。在手术过程中，使用专用的腹腔镜系统来检测夹子发出的吲哚青绿荧光并确定它们的准确位置。这些夹子有助于确定准确的胃切除线，使腹腔镜远端胃切除和区域淋巴清扫成为可能。我们成功地证明了带有荧光树脂的夹子在检测胃癌患者中的有效性。我们报告了第一个案例，使用夹子来准确定位感兴趣的位置。
An asymptomatic 76‐year‐old man presented to our department for the treatment of gastric cancer. Esophagogastroduodenoscopy revealed a superficial elevated lesion with an irregular central depression in the lower third of the stomach; this was confirmed to be adenocarcinoma by biopsy, while abdominal contrast‐enhanced CT revealed no abnormal lesions. Based on the patient's clinical diagnosis of early gastric cancer, we planned laparoscopic gastrectomy with preoperative placement of four endoscopic marking clips equipped with indocyanine green‐conjugated resin to determine the resection margin. During surgery, a dedicated laparoscopic system was used to detect indocyanine green fluorescence emitted by the clips and determine their precise position. The clips helped to identify an accurate resection line for the stomach, enabling accurate laparoscopic distal gastrectomy with regional lymphadenectomy. We successfully demonstrated the usefulness of clips with fluorescent resin for detecting gastric cancer in patients. We report the first case using the clips to accurately locate a site of interest.