摘要目的 探讨荧光腹腔镜在肝细胞癌(HCC)根治性切除术中的临床应用价值.方法 回顾分析2016年6月至2018年6月河南省人民医院113例HCC患者资料.113例HCC患者腹腔镜肝切除(LLR)46例,荧光引导腹腔镜肝切除(FLLR) 67例.结果 LLR组和FLLR组年龄、男性比例、肝功能分级、手术切除方式、手术时间等比较,差异无统计学意义(P＞0.05).LLR组的标本切缘阳性比例明显高于FLLR组,13.0％比3.0％,差异有统计学意义(P＜0.05).FLLR组中22例患者采用吲哚菁绿(ICG)荧光引导解剖性肝切除,正染法10例和负染法12例,注射ICG 2 min后均能观察到荧光显影.正染法和负染法患者手术时间、住院花费、住院时间等比较,差异无统计学意义(P＞0.05).结论 荧光腹腔镜在肝切除术中有一定的优势,能实时可视化显示肝癌边界来保证肿瘤的安全切缘.

abstractsObjective To investigate the clinical application value of fluorescence laparoscopy in radical resection of hepatocellular carcinoma (HCC).Methods Data of totally 113 patients with HCC in Henan Provincial People's Hospital between June 2016 to June 2018 were retrospectively analyzed.Among the 113 patients,46 patients underwent laparoscopic hepatectomy (LLR),and 67 patients underwent fluorescence guided laparoscopic hepatectomy (FLLR).Results No significant differences were observed between LLR group and FLLR group in terms of age,male proportion,liver function classification,surgical resection methods,and operation time (P＞0.05).The positive ratio of specimen surgical margin in LLR group was significantly higher than that in FLLR group,13.0％ vs.3.0％,and the difference was statistically significant (P＜0.05).In the FLLR group,22 patients received fluorescence guided anatomic hepatectomy with indocyanine green (ICG),10 with positive staining and 12 with negative staining,and fluorescence imaging was observed 2 minutes after ICG injection.There was no significant difference in operation time,hospitalization cost and length of stay between positive and negative staining (P＞ 0.05).Conclusion Fluorescence laparoscopy has certain advantages in hepatectomy,and can display the boundary of hepatocellular carcinoma in real time to ensure the safe margin of tumor resection.