Clinical study of ICG-R15 combined with three-dimensional image reconstruction technology in preoperative evaluation of liver cancer
10.3969/j.issn.1671-8348.2024.02.018
- VernacularTitle:ICG-R15联合三维影像重建技术在肝癌术前评估的临床研究
- Author:
Yukang GAO
1
;
Ruikun QIAN
;
Changlin MA
;
Sen QIAO
Author Information
1. 山东第一医科大学研究生院,济南 250117;济宁市第一人民医院肝胆外科,山东济宁 272001
- Keywords:
indocyanine green clearance test;
3D reconstruction;
liver cancer;
liver cirrhosis;
preopera-tive evaluation
- From:
Chongqing Medicine
2024;53(2):257-263
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the advantages of indocyanine green clearance rate at 15 min(ICG-R15)combined with three-dimensional image reconstruction technology in preoperativ evaluation of liver cancer,as well as its impact on the efficacy of liver resection surgery.Methods The data of the patients with liver cancer undergoing preoperative three-dimensional image reconstruction evaluation(experimental group,n=65)and traditional CT evaluation(control group,n=70)in the Jining Municipal First People's Hospital from January 2018 to January 2021 were retrospectively analyzed.All patients performed the ICG-R15 test be-fore operation.In the experimental group,45 cases adopted laparotomy and 20 cases adopted laparoscopic sur-gery,which in the control group had 50 cases and 20 cases,respectively.The data of preoperative laboratory tests,intraoperative related indicators and postoperative laboratory tests were collected in the two groups.The influences between the two kinds of evaluation modes on the effects of laparotomy and laparoscopic surgery in liver cancer were compared.Results In laparotomy,compared with the control group,the operation time and postoperative drainage tube extraction time in the experimental group were significantly shortened,the intrao-perative bleeding volume was significantly decreased,the incidence rate of postoperative complications,direct bilirubin and AST levers on 7 d after operation were significantly decreased(P<0.05);there were no statis-tically significant differences in the intraoperative blood transfusion rate,postoperative hospitalization dura-tion,levels of total bilirubin,ALT and albumin and prothrombin time on 7 d after operation between the two groups(P>0.05).In laparoscopic surgery,compared with the control group,the postoperative hospitalization duration and postoperative drainage tube extraction time in the experimental group were significantly short-ened,the levels of AST and ALT on 7 d after operation were significantly decreased(P<0.05);there was no statistically significant difference in the other observation indicators between the two groups(P>0.05);in the control group,3 cases were converted to laparotomy due to inability to excision during laparoscopic explo-ration.Compared with the control group,the accuracy rate of preoperative evaluation of the number of liver tumors and Couinaud segmentation localization(96.9%vs.85.7%)and preoperative evaluation of liver vas-cular variation(100.0%vs.53.8%)were increased in the experimental group,the percentage of the patients with actual resection range greater than preoperative prediction range was lower(7.7%vs.20.0%),and the differences were statistically significant(P<0.05).There was no statistically significant difference in the accu-racy of preoperative evaluation of portal vein invasion between the two groups(P>0.05).Conclusion ICG-R15 combined with three dimensional reconstruction technology in preoperatively assessing liver cancer has more advantages compared with combined traditional CT,moreover which is conducive to reduce intraoperative bleeding,shorten operation time and has the positive effect on the patients'prognosis.