Application of near-infrared fluorescence imaging of tharacic duct in minimally invasive McKeown esophagectomy
10.3760/cma.j.cn112434-20241014-00249
- VernacularTitle:吲哚菁绿荧光腔镜胸导管显影术在微创McKeown食管癌手术中的临床应用
- Author:
Lei XIA
1
;
Jieyong TIAN
;
Xinyu MEI
;
Mingran XIE
;
Hanran WU
Author Information
1. 中国科学技术大学附属第一医院(安徽省立医院)西区甲状腺外科，合肥 230001
- Publication Type:Journal Article
- Keywords:
Esophageal neoplasms;
Thoracoscopes;
Esophagectomy;
Indocyanine green;
Chylothorax;
Thoracic duct
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(10):630-637
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the feasibility, safety, and short-term efficacy of the application of near-infrared fluorescence imaging of tharacic duct(NFITD) by indocyanine green(ICG) in minimally invasive McKeown esophagectomy(MIME).Methods:The clinical data of the patients underwent MIME for esophageal cancer in the First Affiliated Hospital of University of Science and Technology of China From January 2024 to April 2024 were restrospectively analyzed. There were divided into a indocyanine green imaging of thoracic duct(ITD) group and a non indocyanine green imaging of thoracic duct(NITD) group according to intraoperative visualization of morphological patterns of the thoracic duct. The clinicopathologic factors, preoperative adjuvant therapy, surgery-related indicators, postoperative complications were compared between the two groups.Results:In the comparison of general data between the two groups of patients, there were differences in preoperative neoadjuvant therapy between the ITD group and the NITD group. However, there were no significant differences between the two groups in terms of age, gender, tumor segmentation, degree of differentiation, smoking history, drinking history, and preoperative comorbidities. In the perioperative data, the ITD group had advantages in total pleural effusion volume on the third day after surgery, total hospitalization cost, and intraoperative discovery of thoracic duct injury( P<0.05). In terms of the number of metastatic lymph nodes, the ITD group was higher than the NITD group( P<0.05). There were no significant differences between the two groups in terms of operation time, postoperative hospital stay, total pleural effusion volume on the 1st and 2nd days after operation, whether the thoracic duct was ligated, whether there was thoracic adhesion, pTNM stage, the number of lymph node dissection stations and the number of lymph node dissections. In terms of the minor complications of chylothorax after surgery, the ITD group was significantly less than the NITD group. There was no significant difference in other complications between the two groups of patients. Conclusion:NFITD combined with MIME can be safety and effectively performed for patients with esophageal cancer with significant advantages in reducing postoperative chylothorax.
