Application Of Indocyanine Green In Laparoscopic Low Rectal Cancer Surgery

Objective Rectal cancer is a common digestive tract malignant tumor.Most of the patients with rectal cancer in my country are low rectal cancer.Laparoscopic radical resection of rectal cancer has been in recent years with the continuous development and progress of laparoscopic technology.gradually become routine surgery.However,the majority of rectal cancer patients in our country are patients with low rectal cancer.At the same time,with the continuous advancement of medical technology,people’s requirements for the quality of life are increasing day by day.Therefore,laparoscopic radical resection for low rectal cancer has become a routine operation.However,the incidence of anastomotic leakage in low radical resection for rectal cancer is significantly higher than that in conventional radical resection for rectal cancer.Adequate blood perfusion is beneficial to further reduce anastomotic leakage.The incidence of oral leakage,so how to effectively judge and evaluate the blood supply of the anastomosis,has gradually become a hot spot in the industry.This study will further explore the application of indocyanine green(ICG)fluorescence imaging technology in laparoscopic low rectal cancer surgery.ICG fluorescence imaging technology will be used to evaluate anastomotic blood supply and guide intraoperative decision-making,so as to further clarify indocyanine The application of green in laparoscopic low rectal cancer radical resection can reduce postoperative anastomotic leakage and achieve the purpose of assisting lymph node dissection.Methods This study collected a total of 150 patients with laparoscopic low rectal cancer from September 2018 to August 2021 in the General Department of the Second Affiliated Hospital of Anhui Medical University,and 150 patients with low rectal cancer were used as the research objects for retrospective analysis.,according to whether indocyanine green fluorescence imaging technology was used in the operation or not,they were divided into indocyanine green fluorescence imaging technology group(ICG group)and conventional laparoscopic low rectal cancer radical resection group(control group).There were 70 cases in the ICG group and 80 cases in the control group.The general information and clinical characteristics of the patients were collected: gender,age,body mass index(BMI),American Society of Anesthesiologists(ASA)classification,albumin(Albumin,Alb),comorbidities(mainly including Diabetes,cardiovascular history,radiotherapy history,etc.,the distance between the anastomotic stoma and the anal verge,prophylactic fistula,anastomosis method,operation time,intraoperative blood loss,the number of cases of changes in the position of the predissection and intestinal canal,the incidence of postoperative abdominal infection,The postoperative hospital stay,the incidence of postoperative anastomotic leakage(AL),the related conditions of lymph node detection,and the number of deaths caused by anastomotic leakage were compared between the two groups..Results In the ICG group,there were 15 cases of change in the position of the predetached enterotomy tube,while in the control group,there were only 2 cases,which was significantly more than the control group.In the ICG group,41/80 cases(58.57%)with more than 12 lymph nodes were dissected,while in the control group,31/70 cases(38.75%)with more than 12 lymph nodes were dissected.The dissection in the ICG group was better than that in the control group.Only 4 patients in the ICG group developed postoperative abdominal infection,compared with 12 patients in the control group.The mean postoperative hospital stay of the ICG group was 8.1±2.21 d,and that of the control group was 10.6±6.32 d,indicating that the application of ICG in laparoscopic surgery for low rectal cancer also has certain advantages in reducing postoperative abdominal infection and reducing the length of hospital stay(p<0.05).In terms of postoperative anastomotic fistula as the main observation index,there were only 5 cases of anastomotic fistula in the ICG group,and the anastomotic fistula was in grade A and grade B,while in our control group,there were 14 cases,and grade B and grade C fistula accounted for 11 cases,and the difference was statistically significant(p<0.05).Conclusion The application of indocyanine green in laparoscopic low rectal cancer surgery has a positive impact on the incidence of anastomotic leakage and related complications in postoperative patients in terms of blood supply to the anastomotic stoma,and to a certain extent shortens the length of hospital stay and It reduces the incidence of postoperative anastomotic leakage,has guiding significance for lymph node dissection,improves the prognosis of patients,and reduces the recurrence rate.