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通过光腹腔镜切除超低度直肠癌来减少静脉漏:与BMI分层进行倾向匹配的分析

Wenlong Qiu¹, Gang Hu¹, Zhaodong Xing¹

¹Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.

Updates in surgery

|October 9, 2025

概括

在超低直肠癌手术后,印ocyanine绿色光腹腔镜 (ICG FL) 切除显著减少了静脉漏 (AL),特别是在正常的BMI患者中. 这种技术还可以改善恢复,减少并发症,对高BMI个体有潜在的好处.

科学领域:

结肠直肠手术结肠直肠手术
手术瘤学手术瘤学
最少侵入性的手术

背景情况:

截面泄漏 (AL) 是腹腔镜间切除 (LsISR) 后的关键并发症,用于超低直肠癌.
高体重指数 (BMI) 可能会增加AL的风险,需要改进的手术技术.
印ocyanine绿色光 (ICG FL) 成像在手术期间提供实时可视化.

研究的目的:

评估ICG FL切除在LsISR后减少AL的疗效.
评估ICG FL对患者康复和手术结果的影响.
为了研究ICG FL在正常和高BMI的患者中的有效性.

主要方法:

追溯队列研究比较ICGFL (n=133) 和非FL (n=266) LsISR程序从2012年1月到2023年7月.
使用倾向分数匹配 (PSM) 来控制患者的基线特征.
主要终点:解剖管泄漏率;次要终点:血液损失,淋巴结产量和恢复参数.

主要成果:

在PSM队列中,ICG FL组 (3.0%) 的AL率明显低于非FL组 (9.4%) (P=0.035).
在FL组中,严重的症状性静脉漏 (SSAL) 减少 (0.8%对5.6%,P=0.045).
在正常的BMI患者中,ICG FL表现出显著的AL减少和加速恢复 (更早的肠功能,饮食,更短的住院时间).

结论:

切除ICG FL是有效的减少静脉流泄漏和增强在LsISR后的短期恢复超低直肠癌.
这些益处在正常BMI患者中尤为明显,在高BMI患者中减少AL的趋势.
需要进一步的研究来证实ICG FL在高BMI患者群体中的益处.

关键词:

解剖学上的泄漏.光腹腔镜激光切除术是光腹腔镜的根本切除术.高的BMI高的BMI是一个问题.印度氨酸绿色是绿色的超低水平的直肠癌.

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