Yao W,Dong KR,Li K,et al.Application of indocyanine green fluorescence imagine technique in precise hepatectomy for hepatoblastoma.[J].Journal of Clinical Pediatric Surgery,,18():107-111.
Application of indocyanine green fluorescence imagine technique in precise hepatectomy for hepatoblastoma.
Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R]
volume:
第18卷
Number:
2019 02
Page:
107-111
Column:
论著
Date of publication:
2019-02-25
- Keywords:
- Indocyanine Green; Fluorescence; Liver Neoplasms; Resection Of Tumor Margin; Navigation Surgery
- CLC:
- R729 R735.7 R857.3
- Document code:
- A
- Abstract:
- Objective To explore the imagine characteristics of nearinfrared technology guided by indolecyanine green (ICG)Ｔin hepatoblastoma (HB) and examine the value of this technique for identifying small lesions,defining tumor margin and exploring surgical navigation.MethodsFrom March to June 2018,8 HB patients undergoing hepatectomy were recruited.ICG was injected intravenously at least 24 h before operation.Detecting liver small lesions,defining tumor margins and exploring surgical navigation were performed intraoperatively.After resection,the fluorescent characteristics of tumor was classified and the surgical margin detected and confirmed pathologically.ResultsThere were 4 boys and 4 girls with an average age of 33 (5-132) months.Among them,one patient had tumor recurrence,another one received chemotherapy after biopsy,4 received chemotherapy without biopsy and 2 underwent primary hepatectomy.All tumors showed bright fluorescence and clear boundaries with normal liver tissues.Due to deep location (distance to liver surface>1.5 cm) and small lesion (1.0 cm) of recurrent tumor,the lesion was not found by observation,palpation and ICG fluorescent imaging.Until regular hepatectomy was performed,ICG identified recurrent lesions by splitting liver specimen.According to the classification of fluorescence,4 cases showed total fluorescence.Two underwent primary tumor resection,one received chemotherapy after biopsy and another one had recurrence with a history of hepatitis and liver mild sclerosis.Full fluorescence of tumor was accompanied by diffuse nodular hepatic imaging.Partial fluorescence was detected in another four patients with preoperative chemotherapy.Pathologic examination indicated that fluorescent image was total (n=4),partial (n=1) and mixed fetal and embryonic hepatoblastoma (n=1).All tumor margins were negative and confirmed by ICG and pathology.ConclusionIntraoperative ICG fluorescent imaging for HB patients is both feasible and useful.And the type of fluorescent imaging is correlated with preoperative chemotherapy.This technique has the advantages identifying small viable lesions and confirming no remnant tumor after resection.However,ICG fluorescence imaging has some limitations for deep small tumor foci and liver cirrhosis.
Last Update:
2019-02-26