Navigation surgery using indocyanine green fluorescent imaging for hepatoblastoma patients
Navigation surgery using indocyanine green fluorescent imaging for hepatoblastoma patients
复制标题
DOI：
10.1007/s00383-019-04458-5
复制
发表时间：
2019-05-01
影响因子：
1.8
通讯作者：
Taguchi, Tomoaki
中科院分区：
文献类型：
--
作者：
Souzaki, Ryota;Kawakubo, Naonori;Taguchi, Tomoaki
背景利用吲哚菁绿色（ICG）检测肝肿瘤和识别胆管的技术是近年来发展起来的。然而，ICG导航手术治疗肝母细胞瘤（HB）的有效性和局限性尚未完全阐明。我们在此报告我们的经验与手术导航使用ICG在HB patients.MethodsIn 5 HB患者，10 ICG导航手术进行了10毫米红外荧光成像镜后，静脉注射ICG 0.5mg/kg。结果4例原发性肝肿瘤患者均在术前90.533.7h行ICG导航手术，术中应用ICG的时间为90.533.7h。所有肿瘤均显示来自肝脏表面的强烈荧光。原发性肝肿瘤的ICG导航有助于在手术中检测残端肿瘤残留和对膈肌的侵犯。使用ICG导航进行了6例肺部手术。ICG注射时间为术前21.8 ± 3.4h。转移性肿瘤的大小为7.4 ± 4.1mm（1.2- 15 mm）。在CT检出的11例转移瘤中，ICG能从肺表面检出10例，包括最小的1.2mm。10个ICG阳性肿瘤距肺表面的深度为0.9 ± 1.9mm（0- 6 mm），单个ICG阴性肿瘤的深度为12 mm。结论ICG在HB患者导航手术中的应用有助于肿瘤的识别和确定手术的完整性。然而，在ICG导航手术中，我们必须意识到肿瘤大小和距离表面深度的限制。
BackgroundTechnology for detecting liver tumors and identifying the bile ducts using indocyanine green (ICG) has recently been developed. However, the usefulness and limitations of ICG navigation surgery for hepatoblastoma (HB) have not been fully clarified. We herein report our experiences with surgical navigation using ICG for in HB patients.MethodsIn 5 HB patients, 10 ICG navigation surgeries were performed using a 10-mm infrared fluorescence imaging scope after the injection of 0.5mg/kg ICG intravenously. The surgical and clinical features were collected retrospectively.ResultsNavigation surgery using ICG was performed for primary liver tumors in 4 cases, and the timing of ICG injection was 90.533.7h before the operation. All tumors exhibited intense fluorescence from the liver surface. ICG navigation for the primary liver tumor was useful for detecting the residual tumor at the stump and invasion to the diaphragm during surgery. Six lung surgeries using ICG navigation were performed. The timing of ICG injection was 21.8 +/- 3.4h before the operation. The size of the metastatic tumor was 7.4 +/- 4.1mm (1.2-15mm). Of 11 metastatic tumors detected by computed tomography (CT), 10including the smallest tumor (1.2mm)were able to be detected by ICG from the lung surface. The depth of the 10 ICG-positive tumors from the lung surface was 0.9 +/- 1.9mm (0-6mm), and the depth of the single ICG-negative tumor was 12mm. One lesion not detected by CT showed ICG false positivity.Conclusion Navigation surgery using ICG for patients with HB was useful for identifying tumors and confirming complete resection. However, in ICG navigation surgery, we must be aware of the limitations with regard to the tumor size and the depth from the surface.