Li CG, Zhou ZP, Tan XL, Wang ZZ, Liu Q, Zhao ZM. Robotic resection of liver focal nodal hyperplasia guided by indocyanine green fluorescence imaging: A preliminary analysis of 23 cases. World J Gastrointest Oncol 2020; 12(12): 1407-1415 [PMID: 33362911 DOI: 10.4251/wjgo.v12.i12.1407]
Corresponding Author of This Article
Cheng-Gang Li, MD, PhD, Associate Professor, Second Department of Hepatobiliary Surgery, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. lcgang301@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Cheng-Gang Li, Zhi-Peng Zhou, Xiang-Long Tan, Zi-Zheng Wang, Qu Liu, Zhi-Ming Zhao, Second Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Li CG and Zhou ZP contributed equally to this work and should be considered as co-first authors; Li CG and Zhou ZP analyzed and interpreted the data and wrote the manuscript; Tan XL, Wang ZZ, and Liu Q drafted the work and collected the data; Zhao ZM designed the study and revised the manuscript for important intellectual content.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Chinese PLA General Hospital.
Informed consent statement: All patients involved in the present study provided informed written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cheng-Gang Li, MD, PhD, Associate Professor, Second Department of Hepatobiliary Surgery, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. lcgang301@126.com
Received: August 17, 2020 Peer-review started: August 17, 2020 First decision: September 21, 2020 Revised: September 28, 2020 Accepted: October 26, 2020 Article in press: October 26, 2020 Published online: December 15, 2020
ARTICLE HIGHLIGHTS
Research background
Focal nodal hyperplasia (FNH) is a common benign tumor of the liver. It occurs mostly in people aged 40-50 years and 90% of the patients are female.
Research motivation
How to locate and judge the tumor boundary in real time is often a challenge for surgeons.
Research objectives
To summarize the technique and feasibility of robotic resection of FNH guided by indocyanine green (ICG) fluorescence imaging.
Research methods
The demographics and perioperative outcomes of a series of consecutive patients who underwent robotic resection of liver FNH guided by ICG fluorescence imaging between May 1, 2018 and September 30, 2019 were retrospectively analyzed. ICG was injected through the median elbow vein in all the patients at a dose of 0.25 mg/kg 48 h before the operation.
Research results
Among the 23 patients, there were 11 males and 12 females, with a mean age of 30.5 ± 9.3 years. Twenty-two cases completed robotic resection, while one (4.3%) case converted to open surgery. In the robotic surgery group, the operation time was 35-340 min with a median of 120 min, the intraoperative bleeding was 10-800 mL with a median of 50 mL, and the postoperative hospital stay was 1-7 d with a median of 4 d. Biliary fistula occurred in two (8.7%) patients after robotic operation and they both recovered after conservative treatment. One (4.3%) patient received blood transfusion and there was no death in this study. The postoperative hospital stay in the small tumor group was significantly shorter than that in the large tumor group (P < 0.05).
Research conclusions
Our study shows that ICG is an excellent intraoperative dye developer for FNH, and it is safe and effective to use Da Vinci robot to give such patients complete resection of tumor. In the future, more large-scale case accumulation is needed to further summarize the safety and effectiveness of this method.
