Efficacy of Near-Infrared Fluorescence-Guided Hepatectomy for the Detection of Colorectal Liver Metastases: A Randomized Controlled Trial
Efficacy of Near-Infrared Fluorescence-Guided Hepatectomy for the Detection of Colorectal Liver Metastases: A Randomized Controlled Trial
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DOI：
10.1097/xcs.0000000000000029
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发表时间：
2022-02-01
影响因子：
5.2
通讯作者：
Li, Jian
中科院分区：
文献类型：
--
作者：
He, Kunshan;Hong, Xiaopeng;Li, Jian
背景技术背景：吲哚菁绿色荧光引导下肝切除术治疗结直肠癌肝转移的应用尚处于临床实践的初步阶段，其疗效有待确定。本研究比较了接受传统肝切除术的患者术中检测到的肝内结直肠肝转移的数量和术后恢复数据（非吲哚菁绿色组）和传统肝切除术加术中吲哚菁绿色荧光成像（吲哚菁绿色组）。2018年1月至2020年3月期间，将可能可切除的结直肠肝转移患者随机分配至非吲哚菁绿色或吲哚菁绿色组。肝内结直肠癌肝转移的数量确定术中和术后恢复数据进行了比较between both group.Results：总体而言，我们招募了80例患者，其中72名合格的患者被随机分配。分配后，64例患者（每组32例）接受了分配的干预和随访。与非吲哚菁绿色组相比，吲哚菁绿色组术中发现的肝内结直肠肝转移的平均数量明显更多（平均值[标准差]，3.03 [1.58] vs 2.28 [1.35]; p = 0.045），术后住院时间较短（p = 0.012），1年复发率也较低（p = 0.017）。术后并发症和90天的死亡率是可比的，没有统计学差异conclusions：吲哚菁绿色荧光成像显着增加的肝内结直肠癌肝转移的数量确定，并减少术后住院时间和1年的复发率，而不增加肝切除术相关的并发症和死亡率。(C)2022年美国外科医生学会由Wolters Kluwer Health，Inc.出版。All rights reserved.
BACKGROUND: The application of indocyanine green fluorescence-guided hepatectomy for liver metastases from colorectal cancer is in the preliminary stage of clinical practice; thus, its efficacy needs to be determined. This study compared the number of intrahepatic colorectal liver metastases detected intraoperatively and postoperative recovery data between patients who underwent traditional hepatectomy (nonindocyanine green group) and traditional hepatectomy plus intraoperative indocyanine green fluorescence imaging (indocyanine green group).STUDY DESIGN: Between January 2018 and March 2020, patients with potentially resectable colorectal liver metastases were randomly assigned to the nonindocyanine green or indocyanine green group. The number of intrahepatic colorectal liver metastases identified intraoperatively and based on postoperative recovery data were compared between both groups.RESULTS: Overall, we recruited 80 patients, among whom 72 eligible patients were randomly assigned. After allocation, 64 patients, comprising 32 in each group, underwent the allocated intervention and follow-up. Compared with the nonindocyanine green group, the mean number of intrahepatic colorectal liver metastases identified intraoperatively in the indocyanine green group was significantly greater (mean [standard deviation], 3.03 [1.58] vs 2.28 [1.35]; p = 0.045), the postoperative hospital stay was shorter (p = 0.012) and the 1-year recurrence rate was also lower (p = 0.017). Postoperative complications and 90-day mortality were comparable, with no statistical differences.CONCLUSIONS: Indocyanine green fluorescence imaging significantly increases the number of intrahepatic colorectal liver metastases identified and reduces postoperative hospital stay and 1-year recurrence rate without increasing hepatectomy-related complications and mortality rates. (C) 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.