荧光腹腔镜技术在结直肠外科的应用现状与进展
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1.复旦大学附属肿瘤医院 大肠外二科,上海 200032;2.复旦大学上海医学院 肿瘤学系,上海 200032

作者简介:

李心翔,复旦大学附属肿瘤医院主任医师,主要从事结直肠癌临床与基础方面的研究。

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Current status and advances in the application of fluorescence laparoscopy in colorectal surgery
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1.Department of Colorectal Surgery Ⅱ, Fudan University Shanghai Cancer Center, Shanghai200032, China;2.Department of Oncological Science, Shanghai Medical College, Fudan University, Shanghai200032, China

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    摘要:

    荧光成像技术最初用于肝储备功能评估和乳腺癌前哨淋巴结活检等,随后此方法在肿瘤外科各个领域中的应用得到广泛认可。荧光腹腔镜技术,将荧光成像技术优势和微创优势相结合,这一技术在结直肠癌(CRC)的辅助诊断及治疗方面展现出重要的研究价值和良好的应用前景。在腹腔镜CRC手术中,吲哚菁绿-近红外成像技术可增强肿瘤病灶的可视化效果、进行淋巴结示踪及评估吻合口血供等。近年来,荧光腹腔镜技术发展迅速,但尚处于探索阶段。国内外微创外科专家通过总结现有临床经验,制定了一系列专家共识,为指导腹腔镜结直肠手术提供了指南,但关于吲哚菁绿注射剂量、浓度、给药方式及时间、注射部位及学习曲线等尚无完全统一标准。因此,未来仍需在多中心、大规模的临床试验基础上进一步建立一致性指南,推动该技术在疾病诊断及治疗中规范、广泛的应用。笔者对荧光腹腔镜技术在结直肠外科手术中的发展背景、应用进展、技术争论以及展望进行介绍。

    Abstract:

    Fluorescence imaging technology was initially used for liver reserve function assessment and sentinel lymph node biopsy in breast cancer. Subsequently, its application across various fields of oncologic surgery has gained widespread recognition. Fluorescence laparoscopy combines the advantages of fluorescence imaging and minimally invasive techniques, demonstrating significant research value and promising application prospects in the auxiliary diagnosis and treatment of colorectal cancer (CRC). In laparoscopic CRC surgery, indocyanine green-near infrared imaging technology enhances the visualization of tumor lesions, facilitates lymph node tracing, and assesses anastomotic blood supply. In recent years, fluorescence laparoscopy has developed rapidly but remains in the exploratory stage. Minimally invasive surgical experts at home and abroad have summarized existing clinical experiences and developed a series of expert consensus guidelines for laparoscopic colorectal surgery. However, there is still no fully standardized protocol regarding indocyanine green dosage, concentration, administration method and timing, injection site, and learning curve. Therefore, further multicenter, large-scale clinical trials are needed to establish consistent guidelines, promoting the standardized and widespread application of this technology in disease diagnosis and treatment. Here, the authors introduce the development background, application progress, technical debates, and future prospects of fluorescence laparoscopy in colorectal surgery.

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陈奕宽,翁俊勇,李心翔.荧光腹腔镜技术在结直肠外科的应用现状与进展[J].中国普通外科杂志,2024,33(10):1572-1579.
DOI:10.7659/j. issn.1005-6947.2024.10.003

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  • 收稿日期:2024-07-19
  • 最后修改日期:2024-10-14
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  • 在线发布日期: 2024-11-18