术中吲哚菁绿 (ICG) 和术前 3 维 (3D) 重建在腹腔镜肾上腺切除术中的作用：倾向评...

腹腔镜肾上腺切除术 (LA) 被认为是治疗肾上腺病变的“金标准”，肾上腺病变通常在其他疾病的放射检查过程中被偶然诊断出来。 本研究旨在评估吲哚菁绿 (ICG) 荧光与术前三维重建 (3DR) 在腹腔镜肾上腺切除术围手术期结果方面的术中作用。 据所知，这是第一份比较这些技术的前瞻性病例对照报告。

从 2019 年 1 月 1 日至 2022 年 1 月 31 日，所有年龄≥18 岁并接受腹腔镜经腹膜肾上腺切除术治疗所有肾上腺肿块的连续患者均被前瞻性纳入。 接受标准 LA 的患者和接受术前 3D 重建和术中 ICG 荧光的患者通过年龄、性别、BMI、CCI 评分、ASA 评分、病变组织学、肿瘤侧和 病变直径。 分析了手术时间、失血量、术中和术后并发症、转化率和住院时间的差异。

经过倾向评分匹配分析，获得了一个队列，其中 36 名患者被分为 2 组，每组 18 名患者。 3DR 组患者的手术时间和术中失血量更短（分别为 P=0,004 和 P=0,004）。 两组在住院时间、中转率、术中术后并发症等方面无差异。

在 LA 中使用术中 ICG 和使用 3DR 图像进行术前计划是对手术的一种安全且有用的补充。 此外，观察到手术时间和术中失血量减少。

术中吲哚菁绿 (ICG) 和术前 3 维 (3D) 重建在腹腔镜肾上腺切除术中的作用：倾向评...

图 1
右侧肾上腺嗜铬细胞瘤的 3D 重建，如手术过程中使用的导出 PDF 文件所示。 每个结构都以不同的颜色显示，并且可以根据需要显示、透视或隐藏。 整个重建可以放大并在各个方向旋转。

术中吲哚菁绿 (ICG) 和术前 3 维 (3D) 重建在腹腔镜肾上腺切除术中的作用：倾向评...

图 2
左肾上腺嗜铬细胞瘤的 3D 重建，如 PDF 导出前在软件中可视化。 每个识别的结构都可以用标签指出。

术中吲哚菁绿 (ICG) 和术前 3 维 (3D) 重建在腹腔镜肾上腺切除术中的作用：倾向评...

图 3
右侧嗜铬细胞瘤肾上腺切除术期间 ICG 给药时间为零时的采集 (A)。 染料在 30 英寸 (B) 和 60 英寸 (C) 处的进展，可以看到肾上腺静脉、腔静脉（白色星号）、肾静脉和低荧光病变。

术中吲哚菁绿 (ICG) 和术前 3 维 (3D) 重建在腹腔镜肾上腺切除术中的作用：倾向评...

图 4
在 60 英寸处采集库欣损伤：肾上腺静脉清晰可见（白色箭头）。 由于 ICG 的新陈代谢，肝脏（白色星号）发出强荧光。

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