| Objective: Indocyanine green(ICG)imaging in near-infrared fluorescence laparoscopic radical resection of gastric malignant tumors is still in the preliminary stage of clinical exploration,and its safety and effectiveness are still controversial.The sake of this learning was to inquire into the adhibition significane of indocyanine green(ICG)in laparoscopic radical resection of gastric malignant tumors.The clinical application of ICG mainly includes the role of ICG in intraoperative tumor localization,the contribution of ICG in lymph node progress during D2 lymph node dissection,and the adhibition of ICG in blood supplymentestimate during alimentary canal reconstruction.Methods: collected in May 2018 to September 2020 to Qinghai university hospital surgical oncology(gastrointestinal)see a doctor,and the preoperative gastroscopy and pathological biopsy diagnosed with stomach cancer,the clinical data of patients with surgery against,finally meet the standard set of a total of 78 patients,the patients were randomly divided into ICG(observation group)and the ICG group(control group).The observation group received intraoperative injection of indoocyine green staining and intraoperative radical resection of gastric cancer under fluorescence laparoscopy(a total of 47 patients),while the governanceorganization received standard laparoscopic thorough gastrectomies without indoocyine green labeling(a total of 31 patients).Respectively to compare the clinical general data correlation index,surgery and postoperative recovery,postoperative pathology reports of general information detection,lymph nodes and lymph node metastasis,and measured the gastric specimens fluorescence on the edge of the circle to the tumor markers in distance,to indocyanine green for tumor location is discussed and the digestive tract reconstruction after the anastomosis of the blood supply to assess the situation.Results: The entirefigure of lymph nodes in the observation group was 38(35-49),which was higher than the total number of lymph nodes in the control group [30(25-47)],and the P value was less than 0.05.The number of lymph nodes dissection between the two groups was statistically valid.The number of lymph nodes in groups 1-7 in observation group was 25(19-32),in control group 22(15-31),the number of lymph nodes detected in groups 1-7between the two groups was not statistically valid.The number of lymph nodes detected was 11(7-14)in the observation group and 8(1-8)in the control group,and the diversityentre the two teams was not statistically significant(P>0.05).There was no statistically significant difference in the detection of lymph nodes with metastasis between the two groups(P>0.05).Comparison among groups within the range of D2 lymph node dissection showed that P values of Group 1,Group 4 and Group 12 A were all less than 0.05,and the difference between the observation group and the control group was statistically significant,with P values of 0.019,0.012 and 0.01,respectively.After indocyanine green staining,the distance from the fluorescent green staining edge to the edge of the tumor measured on the gastric specimen after surgery all exceeded the standard range of resection required.According to the criteria of Sherwinter scoring system,the scores of blood supply of anastomotic and duodenal stump in all patients in the observation group were more than or equal to 3 points,and no postoperative anastomotic leakage or duodenal stump leakage occurred in any patient.Conclusion: after dyeing tag ICG in fluorescence under laparoscopic gastric malignant tumor of the radical resection is safe,also has the feasibility,its role is lymph node navigation makes intraoperative operator can more accurate and thorough in gastric cancer,D2 lymph node radical indocyanine green intraoperative tumor localization function can provide a more precise edge,the stomach for laparoscopic radical prostatectomy has certain guiding significance,intraoperative application indocyanine green blood supply of anastomotic and duodenal stump assessment can reduce postoperative anastomotic leakage or duodenal stump leakage occurred. |
PDF Full Text Request