| Objective:By injecting indocyanine green(ICG)into gastric cancer patients under endoscope before surgery,relevant intraoperative and postoperative data were statistically compared,so as to explore the feasibility,safety and clinical effect of the application of fluorescence laparoscopic indocyanine green(ICG)staining in radical gastrectomy.Methods:In this study,the clinical data of 43 patients with gastric cancer who underwent radical gastrectomy in the Gastrointestinal Surgery Department of Yijishan Hospital,the First Affiliated Hospital of Wannan Medical College from September 2019 to March 2023 were retrospectively analyzed.All patients were pathologically confirmed as gastric cancer by gastroscopy biopsy in our hospital or other hospitals before surgery,According to the operation method,14 cases were divided into observation group(fluorescence laparoscopic group)and 29 cases were control group(conventional laparoscopic group).Preoperative examinations were completed to evaluate the preoperative staging of patients.In the observation group,ICG solution was injected under the mucosa at 3 o ’clock and 9 o ’clock of the tumor under the endoscope within24 h before surgery.Using the "sandwich" method,At each injection site,0.5m L of normal saline was first injected submucosa to lift the tumor,then0.5m L of the configured ICG solution was injected,and finally 0.5m L of normal saline was injected for plugging to prevent ICG leakage.After intraoperative exploration,the colored lymph nodes under fluorescent laparoscopy were picked up,placed into a specimen bag,fixed and submitted for examination.The remaining specimens were dissected by the surgeon after the operation,and lymph nodes in the tumor area were detected as far as possible.The control group was not injected with ICG,Due to the inclusion criteria and the limited number of patients,the enrolled patients in this study were selected from the whole gastrointestinal surgery department,In addition,all operations were performed by senior surgeons with titles of associate senior or above in the undergraduate department Lymph nodes were collected and sent to pathology department for pathological analysis.The operative time(min),intraoperative blood loss(ml),the number of lymph nodes detected,the duration of postoperative hospitalization(d),the time of first postoperative exhaust(d),the duration of postoperative indwelling time of drainage tube(d)and the occurrence of postoperative complications were statistically recorded in the two groups.Results:None of the 14 patients in the experimental group showed any discomfort after Indocyanine Green(ICG)injection.The general clinical data and postoperative complications of the two groups were compared,and there was a certain comparability between the two groups,but the difference was not statistically significant(P > 0.05).The observation group compared to the control group,In the observation group,first ventilation duration(2.64±0.633 VS 2.86±0.639),pain VAS(1.21±0.426 VS 1.24±0.435)at 24 h after surgery,pain VAS(1.07 ±0.475 VS 1±0.535)at 48 h after surgery and after surgery There was no significant difference in pain VAS(0.43±0.514 VS 0.55± 0.506)at 72 h compared with the control group.The operative duration(173.57±45.969 VS 224.14±55.631)(P <0.05),intraoperative blood loss(16.43±10.082 VS 33.45±29.794)(P <0.05),the number of lymph nodes dissection(33.43±6.248 VS)22.41±6.706)(P < 0.05),postoperative drainage tube retention time(8.86±1.791 VS11.52±2.681)(P < 0.05),postoperative hospitalization time(9.64±1.823 VS 12.24±2.708)(P < 0.05),There were statistical differences between the observation group and the control group.Conclusion:Indocyanine green(ICG)labeling technology is safe and feasible in the application of fluorescent laparoscopic radical gastrectomy in patients with gastric cancer,During the study,there were no obvious adverse reactions in all patients injected indocyanine green(ICG)in the experimental group.The labeling and tracer function of ICG can effectively increase the number of lymph nodes dissected during radical gastrectomy,so as to better achieve the purpose of radical resection,and play a positive guiding role in the postoperative staging and treatment evaluation of patients.In addition,compared with the non-ICG group,indocyanine green(ICG)-guided patients undergoing laparoscopic radical gastrectomy have more advantages in terms of postoperative hospital stay(min)and catheter extraction and drainage retention time.Therefore,the application of ICG in laparoscopic radical gastrectomy,It has certain clinical application value. |
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