Original Article
Application of indocyanine green-fluorescent imaging technique in planning resection line and real-time surgical navigation in small hepatocellular carcinoma
Chihua Fang, Hongbo Liang, Chongwei Chi, Haisu Tao, Cheng Fang, Wen Zhu, Zhikang Mo, Jian Yang, Nan Xiang, Ning Zeng, Jie Tian
Published 2016-06-01
Cite as Chin J Surg, 2016, 54(6): 444-450. DOI: 10.3760/cma.j.issn.0529-5815.2016.06.011
Abstract
ObjectiveTo explore the value of near-infrared technology guided by indolecyanine green(ICG) in planning resection line and real-time surgical navigation in small liver cancer.
MethodsFrom March to September 2015, 11 patients with hepatic tumors received hepatectomy were treated in First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University.There were 5 male and 6 female patients with average age of (55±10)years (range 39-70 years). Among whom, there were 9 cases with hepatocellular carcinoma and 2 cases with colorectal cancer. A near-infrared light camera system was used to detect the liver surfaces before resection, and to plan resection line and surgical specimens. A student's t test was used to compare continuous parametric variables.
ResultsThe ICG-fluorescent imaging and histological examination had been used in the 15 lesions of the 11 patients. Among the 15 lesions, 7 lesions were detected by visual inspections, palpation and ICG-fluorescent imaging, 6 lesions were identified only by ICG-fluorescent imaging, 2 lesions were detected only by ICG-fluorescent imaging after resection.Results of pathologic examination indicated that the total fluorescent type include 5 well differentiated hepatocellular carcinoma and 2 cirrhotic nodule; the partial fluorescent type include 3 moderately differentiated hepatocellular carcinomas and 1 well differentiated hepatocellular carcinomas; the rim fluorescent type included 2 liver metastatic carcinoma and 2 poorly differentiated hepatocellular carcinomas. The average diameter of the tumor size measured by CT was (1.7±0.2)cm, while the average diameter measured by ICG-fluorescent imaging was (1.7±0.3)cm(t=-0.188, P>0.05).
ConclusionNear-infrared technology guided by ICG has important value in planning resection line and real-time surgical navigation in small liver cancer.
Key words:
Liver neoplasms; Indocyanine green; Resection margins of tumor; Surgical navigation
Contributor Information
Chihua Fang
First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
Hongbo Liang
Chongwei Chi
Haisu Tao
Cheng Fang
Wen Zhu
Zhikang Mo
Jian Yang
Nan Xiang
Ning Zeng
Jie Tian