Application of fusion indocyanine green fluorescence imaging in the surgical treatment of recurrent hepatocellular carcinoma in 12 cases / 中国实用外科杂志

ABSTRACT

OBJECTIVE: To investigate the application value of fusion indocyanine green fluorescence imaging(FIGFI)in the surgical treatment of recurrent hepatocellular carcinoma.METHODS: From January 2015 to January 2018,theclinical data of 12 patients with recurrent hepatocellular carcinoma who received surgical treatment guided by three-dimensional visualization technology combined with FIGFI at Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University were analyzed. High-quality thin-slice CT data were collected for three-dimensionalvisualization and reconstruction,individualized liver segmentation and preoperative surgical planning. FIGFI was used todefine the demarcation of tumors,to determine the extent of hepatectomy,and to detect small hepatocellular carcinomaand metastases during the operation. The use of FIGFI in combination with three-dimensional visualization imagesguided the precision hepatectomy. postoperative efficacy was observed by follow-up.RESULTS: All the 12 patientsunderwent successful three-dimensional reconstruction and liver resection. Preoperative CT revealed 12 lesions(80%);intraoperative FIGFI detected 15 lesions(100%);of the three newly discovered lesions,2 were hepatocellular carcinomaand 1 was cirrhosis nodule. The operation time was 267.5(183,345)minutes and the amount of bleeding was 287.5(62.5,513.5)m L. No severe complications such as abdominal hemorrhage,abdominal infection,bile leakage and liverfailure occurred postoperatively. No death occurred during the perioperative period. The median follow-up period was 29 (3-36)months; during the follow-up period, 1 casewas lost and 4 cases had metastasis or recurrence.All the patients were alive at the end of the follow-up.CONCLUSION: FIGFI is helpful to achieveanatomical, functional and radical hepatectomy inthe treatment of recurrent hepatocellular carcinoma.