Abstract:

Objective　To explore the application value of indocyanine green-near infrared (ICG-NIR) imaging technology in laparoscopic radical resection of left-sided colon cancer. Methods　A total of 90 patients who underwent laparoscopic left hemicolectomy at Jiangmen Wuyi Hospital of Chinese Medicine from May 2022 to March 2025 were selected as the research subjects. Using the random number table method, the patients were divided into the control group and the observation group, with 45 cases in each group. There were 31 males and 14 females in the control group, aged (53.21±5.28) years, course of the disease (1.63±0.32) years. There were 32 males and 13 females in the observation group, aged (54.39±5.14) years, course of the disease (1.61±0.28) years. The control group did not use indocyanine green (ICG) solution as the tracer for laparoscopic surgery, while the observation group used ICG solution as the tracer for laparoscopic surgery. The perioperative indicators were compared between the two groups (intraoperative blood loss, operation duration, postoperative exhaust time, and total hospital stay), the postoperative lymph node dissection situation (number of lymph nodes detected, number of positive lymph nodes, and lymph node metastasis), and the postoperative complication occurrence (anastomotic leakage, incision infection, and pulmonary infection). Independent sample t test, and χ² test were used for statistical analysis. Results　The intraoperative blood loss in the observation group was less than that in the control group [(106.45±4.85) ml vs. (150.56±5.23) ml], and the operation duration, postoperative exhaust time, and total hospital stay were all shorter [(101.45±4.81) min vs. (112.56±4.67) min, (2.14±1.12) d vs. (3.56±1.25) d, (8.46±1.64) d vs. (12.15±1.78) d] (all P<0.05). There was no statistically significant difference in the number of positive lymph nodes between the two groups (P>0.05). The number of lymph nodes detected in the observation group was higher than that in the control group [(16.42±2.14) vs. (12.21±2.23)], and the proportion of lymph node metastasis in the observation group was lower than that in the control group [28.89% (13/45) vs. 51.11% (23/45)] (both P<0.05). The total incidence of postoperative complications in the observation group was lower than that in the control group [4.44% (2/45) vs. 17.78% (8/45)] (P<0.05). Conclusions　The ICG-NIR imaging technique can accurately locate the tumor and its boundaries during laparoscopic radical resection of left-sided colon cancer. It can shorten the operation duration, reduce the amount of bleeding, increase the number of lymph nodes detected, decrease the proportion of patients with lymph node metastasis and the incidence of postoperative complications.

Key words:

Laparoscopy, Indocyanine green, Near infrared imaging technology, Left-sided colon cancer

摘要：

目的　探讨吲哚菁绿-近红外（ICG-NIR）显像技术在腹腔镜左半结肠癌根治术中的应用价值。方法　选取2022年5月至2025年3月在江门市五邑中医院接受腹腔镜左半结肠癌根治术的患者90例作为研究对象。采用随机数字表法，将患者分为对照组和观察组，各45例。对照组男31例，女14例；年龄（53.21±5.28）岁；病程（1.63±0.32）年。观察组男32例，女13例；年龄（54.39±5.14）岁；病程（1.61±0.28）年。对照组未采用吲哚菁绿（ICG）溶液作为示踪剂进行腹腔镜手术，观察组采用ICG溶液作为示踪剂进行腹腔镜手术。比较两组围手术期指标（术中出血量、手术用时、术后排气时间和总住院时间）、术后淋巴结清扫情况（淋巴结检出数目、阳性淋巴结数目、淋巴结转移）、术后并发症发生情况（吻合口漏、切口感染、肺部感染）。采用独立样本t检验和χ²检验进行统计学分析。结果　观察组术中出血量少于对照组［（106.45±4.85）ml比（150.56±5.23）ml］，手术用时、术后排气时间、总住院时间均短于对照组［（101.45±4.81）min比（112.56±4.67）min、（2.14±1.12）d比（3.56±1.25）d、（8.46±1.64）d比（12.15±1.78）d］（均P<0.05）。两组阳性淋巴结数目比较，差异无统计学意义（P>0.05）。观察组淋巴结检出数目多于对照组［（16.42±2.14）个比（12.21±2.23）个］，淋巴结转移占比低于对照组［28.89%（13/45）比51.11%（23/45）］（均P<0.05）。观察组术后并发症总发生率低于对照组［4.44%（2/45）比17.78%（8/45）］（P<0.05）。结论　ICG-NIR显像技术在腹腔镜左半结肠癌根治术中能够准确定位肿瘤及其边界，可缩短手术用时，减少出血量，提高淋巴结检出数目，降低淋巴结转移患者占比和术后并发症发生率。

关键词:

腹腔镜, 吲哚菁绿, 近红外显像技术, 左半结肠癌