结直肠肛门外科 (Oct 2023)
The Application value of indocyanine green fluorescence imaging in left colon mesentery dissection during laparoscopic colorectal cancer surgery
Abstract
[Objectives] To explore the application value of indocyanine green fluorescence imaging in the dissection of the left colon mesentery during laparoscopic colorectal cancer surgery. [Methods] A retrospective analysis was conducted on the clinical data of patients with left colon cancer and upper rectal cancer who underwent laparoscopic radical resection in the Department of Colorectal Surgery, Guangdong Provincial Hospital of Chinese Medicine, from December 2020 to February 2023. Based on whether indocyanine green fluorescence imaging was used to guide the surgery, patients were divided into a fluorescence staining group (n＝109) and a control group (n＝469). Intraoperative and postoperative conditions, along with postoperative complications, were compared between the two groups. This analysis aimed to explore the benefits of laparoscopic colorectal cancer surgery guided by indocyanine green fluorescence imaging in left colon mesentery dissection. [Results] In the fluorescence staining group (n＝109), 100 (91.74%) patients could observe the blood supply of the colon marginal artery during surgery, and the main branches of the inferior mesenteric artery were clearly visualized. There were no significant differences in surgical time, incidence of postoperative anastomotic leakage, number of lymph nodes detected at N1 and N3 station, and number of positive lymph nodes detected between the two groups (P>0.05). Compared with the control group, indocyanine green fluorescence group had fewer intraoperative blood loss, the number of lymph nodes detected at N2 station and the incidence of anastomotic leakage (P<0.001). The postoperative hospital stay of the indocyanine green fluorescence group was shorter than that of the control group (P<0.05). [Conclusion] Indocyanine green can effectively visualize the blood supply of important blood vessels in laparoscopic colorectal cancer surgery. Guided by indocyanine green fluorescence imaging, the dissection of the mesentery and blood vessels can be performed with enhanced safety.
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