实时虚拟导航系统联合吲哚氰绿染色在原发性肝癌解剖性肝切除术中的应用研究进展

摘要/Abstract

摘要： 目前原发性肝癌的首选治疗方法是肝切除术。然而,肝切除术后复发率较高,总体治疗效果并不令人满意。解剖性肝切除术预后优于非解剖性肝切除术,但在解剖性肝切除术中,如何识别肿瘤边界、肝内微小病灶及肝段的切离线,仍然是临床面临的难题。近年来,实时虚拟导航系统（real-time virtual navigation system,RVS）逐渐应用于临床。RVS是将超声与CT、MRI等影像学图像完全融合,其对肝癌病灶与周围正常肝脏组织的分辨能力及定位检出率优于常规术中超声。吲哚氰绿（indocyanine green,ICG）荧光染色可以标记微小转移病灶及肝段切离线。术中应用RVS实时动态导航联合ICG染色,最终完成精准解剖性肝切除术,可以提高R0切除率,降低原发性肝癌的术后复发率及转移率,改善患者预后。

关键词: 原发性肝癌, 解剖性肝切除术, 吲哚氰绿染色, 实时虚拟导航系统

Abstract: The current preferred treatment for primary hepatic carcinoma is hepatectomy. However, the recurrence rate after hepatectomy is high, and the overall treatment effect is not satisfactory. The prognosis of anatomical liver resection is better than that of non-anatomical liver resection, which is gradually accepted by everyone. However, in anatomical liver resection, how to identify the tumor boundary, small intra-hepatic lesions, and the segmentation of the liver segment is still clinically facing problem. In recent years, real-time virtual navigation system (RVS) technology has been gradually applied in clinics. RVS is a complete fusion of ultrasound and CT, MRI and other imaging images. Its resolution and localization detection rate of liver cancer lesions and surrounding normal liver tissues are better than conventional intraoperative ultrasound. Indocyanine green (ICG) fluorescent staining can mark micrometastasis and liver segmentation off-line. Previous studies have shown that the use of RVS real-time dynamic navigation combined with ICG staining during surgery to eventually complete accurate anatomical liver resection can increase R0 resection rate, reduce the postoperative recurrence rate and metastasis rate of primary hepatic carcinoma, and improve primary hepatic carcinoma prognosis.

Key words: Primary hepatic carcinoma, Anatomical liver resection, Indocyanine green staining, Real-time virtual navigation system

窦晓伟, 王强, 蒲昌盛, 师稳再, 索晓鹏, 吴宪佳, 吴田田, 蔡俊, 程志雷, 田远虎, 陈建飞, 张克明. 实时虚拟导航系统联合吲哚氰绿染色在原发性肝癌解剖性肝切除术中的应用研究进展[J]. 肝癌电子杂志, 2021, 8(4): 31-35.

Dou Xiaowei, Wang Qiang, Pu Changsheng, Shi Wenzai, Suo Xiaopeng, Wu Xianjia, Wu Tiantian, Cai Jun, Cheng Zhilei, Tian Yuanhu, Chen Jianfei, Zhang Keming. Progress of application of real-time virtual navigation system combined with indocyanine green staining in anatomical liver resection of primary hepatic carcinoma[J]. Electronic Journal of Liver Tumor, 2021, 8(4): 31-35.

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