Peng Yumin,Yin Qiang,Gao Hongqiang,et al.Anatomic right-half of indocyanine green fluorescent staining hepatectomy for children with liver tumors.[J].Journal of Clinical Pediatric Surgery,2018,17(07):0.[doi:10.3969/j.issn.1671-6353.2018. 201805057]
吲哚菁绿荧光染色引导下解剖性右半肝切除治疗儿童肝脏肿瘤
- Title:
- Anatomic right-half of indocyanine green fluorescent staining hepatectomy for children with liver tumors.
- Keywords:
- Indocyanine Green; Fluorescent Staining; Liver Neoplasms; Dissection; Child
- 摘要:
- 目的 探讨吲哚菁绿(ICG)荧光染色引导解剖性右半肝切除术在儿童肝脏肿瘤中应用价值。方法 回顾性研究分析湖南省儿童医院收治的一例儿童肝母细胞瘤,采用经外周静脉注射ICG,通过“反染法”标记半肝断面,成功完成荧光引导下解剖性右半肝切除术的临床资料。探讨儿童ICG使用剂量、染色方式、肝脏及肝外胆道染色时间指标,染色断面对肝脏切除平面的指导意义。结果 应用ICG荧光染色引导下完成解剖性右半肝切除术,术中肝脏染色满意,肝外胆道染色显影清晰,术中出血150ml,手术时间300min。术后肝功能下降至正常,恢复顺利。结论 应用ICG荧光染色引导对儿童解剖性肝脏切除有重要价值,可能成为全新的儿童解剖性肝切除手术方式;但对于ICG荧光染色成功率、安全性及对预后的影响还需大样本量病例的对比研究。
- Abstract:
- Objective To explore the value of indole cyanine green (ICG) fluorescent staining in guiding anatomic right-half hepatectomy in pediatric liver tumors. Methods For one hospitalized child of hepatoblastoma, ICG was injected into peripheral veins and semi-hepatic section was marked by "reverse staining method" for completing fluorescence guided anatomic right hemicectomy. To explore the dosage, staining method, liver and extrahepatic biliary tract staining time index of children with ICG, and the guiding significance of staining and breaking in the face of liver resection plane. Results ICG fluorescence staining was employed for guiding the successful completion of anatomic right-half hepatectomy. Liver was stained satisfactorily during operation and intraoperative bile duct staining showed distinct imaging. With an intraoperative bleeding volume of 150 mL, operative duration was 300 min. After operation, patient recovery was excellent and liver functions decreased to normal. Conclusion The application of ICG fluorescence staining can accurately guide children’s anatomic liver resection. It is of great value for treating children’s liver tumors. However, a comparative study on success rate, safety and prognosis of ICG fluorescence staining requires a large number of cases.
参考文献/References:
[1].1 Allan BJ, Parikh PP, Diaz S, et al. Predictors of survival and incidence of hepatoblastoma in the paediatric population[J]. HPB (Oxford), 2013,15(10):741-746.
[2].2 Xu M, Chen QM. Model of multidisciplinary team treatment on hepatoblastoma in children[J]. J Appl Clin Pediatr, 2008, 23(11) :829-830
[3].3 Makuuchi M, Hasegawa H, Yamazaki S. Ultrasonically guided subsegmentectomy[J]. Surg Gynecol Obstet, 1985,161(4):346-350.
[4].4 Takasaki K. Glissonean pedicle transection method for hepatic resection: a new concept of liver segmentation[J]. J Hepatobiliary Pancreat Surg, 1998, 5(3):286-291.
[5].5 Inoue Y, Arita J, Sakamoto T, et al. Anatomical liver resections guided by 3-dimensional parenchymal staining using fusion indocyanine green fluorescence imaging[J]. Annals of surgery, 2015, 262(1):105-111.
[6].6 王宏光, 陈明易, 许寅喆. 吲哚菁绿荧光融合影像引导的腹腔镜解剖性肝切除术[J]. 中华普外科手术学杂志(电子版), 2017(05):372.
[7]. Wang RG, Chen MY, Xu YZ. Laparoscopic anatomical liver resections guided by fusion indocyanine green fluorescence imaging[J]. Chinese Journal of Operative Procedures of General Surgery (Electronic Edition), 2017(05):372.
[8].7 Ishizawa T, Fukushima N, Shibahara J, et al. Real-time identification of liver cancers by using indocyanine green fluorescent imaging[J]. Cancer, 2009, 115(11):2491-2504.
[9].8 王宏光. 吲哚菁绿荧光融合影像引导下腹腔镜解剖性肝切除术一例[J]. 肝癌电子杂志, 2017(01):57-58.
[10]. Wang RG. Laparoscopic anatomical liver resection guided by fusion indocyanine green fluorescence imaging: one case report[J]. Electronic Journal of Liver Tumor, 2017(01):57-58.
[11].9 Miyata A, Ishizawa T, Tani K, et al. Reappraisal of a dye-staining technique for anatomic hepatectomy by the concomitant use of indocyanine green fluorescence imaging[J]. J Am Coll Surg, 2015, 221(2):e27-e36.
[12].10 Wakabayashi G, Cherqui D, Geller DA, et al. Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka[J]. Annals of Surgery, 2015, 261(4):619-629.
相似文献/References:
[1]彭宇明,尹强,高红强,等.吲哚菁绿荧光染色引导下解剖性右半肝切除治疗儿童肝脏肿瘤[J].临床小儿外科杂志,2018,17(08):597.
Peng Yumin,Yin Qiang,Gao Hongqiang,et al.Anatomic righthalf of indocyanine green fluorescent staining hepatectomy for children with liver tumors.[J].Journal of Clinical Pediatric Surgery,2018,17(07):597.
备注/Memo
(收稿日期:2018-05-24)本文引用格式:彭宇明,尹强,高红强,等.吲哚菁绿荧光染色引导下解剖性右半肝切除治疗儿童肝脏肿瘤[J].临床小儿外科杂志,2018,17( ): DOI:10.3969/j.issn.1671-6353.2018. 201805057.Citing this article as: Peng YM, Yin Q, Gao HQ, et al. Anatomic right half of indocyanine green fluorescence staining hepatectomy for children with liver tumors[J]. J Clin Ped Sur, 2018, DOI:10.3969/j.issn.1671-6353. 201805057.作者单位:湖南省儿童医院普外一科(湖南省长沙市,410007)