Ureteral navigation using a fluorescent ureteral catheter during laparoscopic colorectal surgery
Ureteral navigation using a fluorescent ureteral catheter during laparoscopic colorectal surgery
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腹腔镜结直肠手术期间使用荧光输尿管导管进行输尿管导航
DOI：
10.1007/s00464-021-08538-3
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Y. Nakabayashi
中科院分区：
文献类型：
--
作者：
Shunjin Ryu;Atsuko Okamoto;Keigo Nakashima;Keigo Hara;Kota Ishida;Ryusuke Ito;Y. Nakabayashi
背景 输尿管损伤是盆腔手术最常见的泌尿外科并发症，据报道结肠切除术中的发生率为 0.3-1.5%。输尿管支架置入术通常在术前进行，以防止输尿管损伤。由于腹腔镜手术中触觉不可靠，输尿管支架的效果被认为是有限的。最近，荧光成像已被用于腹腔镜手术。近红外线导管（NIRC™）荧光输尿管导管（NIRFUC）是一种内置近红外荧光树脂的新型导管。本试验研究旨在评估腹腔镜结直肠手术期间使用 NIRFUC 进行荧光输尿管导航的实用性。方法 我们评估了 2020 年 2 月至 7 月期间在川口市医疗中心接受结直肠手术的 20 名患者的 NIRFUC 术中效用和短期结果。总共包括 18 名恶性肿瘤患者和 2 名良性疾病（即乙状结肠膀胱瘘）患者。 10 名患者术前出现肠梗阻。一名患者术前发生穿孔。九名患者术前出现瘤周脓肿。使用 VISERA ELITE2 系统进行腹腔镜手术。结果 在所有情况下，输尿管都可以非常清楚地识别为荧光，无需解剖。在所有情况下，只需片刻即可通过荧光观察识别输尿管。在所有病例中均进行了 R0 切除。平均手术时间为 334 分钟（161-1014），平均失血量为 10 毫升（1-500），平均术后住院时间为 11 天（8-47）。无输尿管损伤病例。结论 手术过程中，NIRFUC 瞬间荧光识别非常清晰，无需解剖输尿管周围。使用 NIRFUC 的荧光输尿管导航可以使结直肠手术变得更容易，并有助于完成复杂的微创手术，特别是在对周围组织有侵犯或有盆腔手术或放射史的患者进行手术期间。
Background Ureteral injury is the most common urological complication of pelvic surgery, with a reported incidence during colon resection of 0.3–1.5%. Ureteral stenting is commonly performed preoperatively to prevent ureteral injury. Because tactile sensation is not reliable during laparoscopic surgery, the effect of the ureteral stent is considered limited. Recently, fluorescence imaging has been used in laparoscopic surgery. The Near-Infrared Ray Catheter (NIRC™) fluorescent ureteral catheter (NIRFUC) is a new catheter with built-in NIR fluorescent resin. This pilot study was performed to evaluate the utility of fluorescence ureteral navigation using the NIRFUC during laparoscopic colorectal surgery. Methods We evaluated the intraoperative utility of the NIRFUC and the short-term outcomes in 20 patients treated with colorectal surgery at Kawaguchi Municipal Medical Center between February and July 2020. In all, 18 patients with malignant tumors and 2 patients with benign disease, i.e., a sigmoid colovesical fistula, were included. Ten patients developed preoperative intestinal obstruction. One patient experienced preoperative perforation. Nine patients developed preoperative peritumoral abscesses. Laparoscopic surgery was performed with the VISERA ELITE2 system. Results In all cases, the ureters were very clearly identified as fluorescent without the need for dissection. In all cases, only a moment was required to identify the ureter by fluorescence observation. In all cases, R0 resection was performed. The mean surgical duration was 334 min (161–1014), the mean blood loss was 10 ml (1–500), and the mean postoperative hospital stay was 11 days (8–47). There were no cases of ureteral injury. Conclusion The NIRFUC was very clearly identified as fluorescent in a moment during surgery without dissection around the ureter. Fluorescence ureteral navigation using the NIRFUC may make colorectal surgery easier and facilitate completion of complex minimally invasive surgery, especially during surgery in patients with invasion of the surrounding tissue or a history of pelvic surgery or radiation.
使用 VISERA ELITE2 进行 ICG 荧光法评估腹腔镜结直肠癌手术中的吻合情况
影响因子：
2
作者：
２）Shunjin Ryu;Katsuhito Suwa;Takahiro Kitagawa;Marie Aizawa;Takurou Ushigome;Tomoyoshi Okamoto;Ken Eto;Katsuhiko Yanaga
通讯作者：
Katsuhiko Yanaga
影响因子：
3.3
作者：
Hashiguchi, Yojiro;Muro, Kei;Sugihara, Kenichi
通讯作者：
Sugihara, Kenichi