| Objective: Lymph node dissection and digestive tract reconstruction are important issues to be solved in colon cancer surgery.Indocyanine green(ICG)imaging technology has been widely used in clinical practice in recent years.The purpose of this study was to investigate its application value in laparoscopic colorectal cancer surgery.Methods: A retrospective analysis of the clinical case data of 234 patients who underwent laparoscopic radical resection of colorectal cancer from July 2019 to December 2020 in the Department of Gastrointestinal Surgery,the Third Xiangya Hospital of Central South University.The patients were divided into ICG group(37 cases)and non-ICG group(197 cases)according to whether the ICG imaging system was used in surgery.There was no significant difference in sex,age,BMI,TNM staging,ASA staging,and other general data between the two groups.Compare and analyze the differences in the following three aspects:1.Patients’ intraoperative condition and unplanned disposal rate2.Lymph node detection rate and postoperative pathological results 3.AL and other complications occurred 30 days after operation.SPSS22.0software was used for statistical analysis,continuous variable data conforming to a normal distribution are recorded as((?)±s),The independent samples t-test was used for the comparison.the non-normal distribution was expressed as the median(P25,P75),and the Mann-Whitney U test was used for comparison.Enumeration data were recorded in the form of quantity,compared with χ~2-test and Fisher exact test.P<0.05 was considered statistically significant.Results:(1)Intraoperative condition: among the 37 patients with ICG-NIR system,10 patients underwent radical resection of right colon cancer and 27 patients with left colon and rectal cancer.35 patients had good blood circulation,only 2 patients had re-anastomosis due to poor blood circulation,3 patients underwent prophylactic colostomy,the intraoperative blood loss was 87±48m L,and the operation time was195(180,240)min.In the non-ICG group,58 patients underwent radical resection of right colon cancer and 139 patients of left colon and rectal cancer.The intraoperative blood loss was 98±40m L,operation time was220(195,255)min,and preventive fistulostomy was performed in 20 cases.There was no significant difference in intraoperative blood loss,operation methods and operation time between the two groups.The difference in unplanned disposal rate between the two groups was statistically significant(P=0.024).(2)The mean number of lymph nodes detected in ICG group(17.37±5.27)was higher than non-ICG group(14.29±3.06)(P=0.002),and the number of lymph node dissection <12was lower than non-ICG group(P=0.02),the difference was statistically significant.However,there was no statistically significant difference in number of positive lymph nodes,metastasis degree and lymph node metastasis rate between the two groups(P>0.05).(3)postoperative conditions and complications: In the ICG group,the first exhaust time was3(3,4)days,the postoperative hospital stay was 10(9,12)days,and 2patients developed complications(2/37),including 1 developed AL.In the non-ICG group,the first exhaust time was 3(3,4)days,and the postoperative hospital stay was 10(9,13)days.16 patients developed complications(16/197),including 11 cases of AL(5.5%).There was no significant difference in the time of first exhaust,hospitalization days,AL rate and incidence of complications between the two groups(P>0.05).Conclusion: ICG fluorescence laparoscopy is safe and feasible for radical resection of colorectal cancer.It can guide lymph node dissection to improve operation quality,and assist real-time evaluation of intestinal perfusion.However,it did not show advantages in reducing anastomotic leakage and comprehensive complications. |
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