关键词: 吲哚菁绿荧光反染法, 三维电视胸腔镜肺段切除术, 改良膨胀萎陷法, Ⅰ期肺癌, 生活质量, 并发症, 肺功能

Abstract: Objective To observe the efficacy and safety of 3D video-assisted thoracoscopic segmentectomy in patients with stage Ⅰ lung cancer treated with indocyanine green (ICG) fluorescence reverse-staining.Methods A total of 132 patients with stage Ⅰ lung cancer who were admitted from May 2022 to September 2024 all underwent three-dimensional video-assisted thoracoscopic segmental resection of the lung. They were divided into the observation group (63 cases) and the control group (69 cases) according to the method of intersegmental plane exposure. The control group was treated with the modified expansion and collapse method, while the observation group was treated with the ICG fluorescence backstaining method. The surgical conditions, pulmonary function, postoperative pain degree, quality of life and complications of the two groups were compared. Results The postoperative chest tube retention time, surgical time, postoperative hospitalization time, total postoperative thoracic drainage volume,and inter-segmental plane exposure time in the observation group were as follows(2.13±0.37) d，(145.12±25.26) min，(5.21±0.95) d，(261.41±28.57) ml and (9.15±1.73) s,respectively.The data of the control groups were (3.29±0.48) d,(178.31±30.45) min,(6.34±1.36) d,(352.03±36.74) ml and (1 651.28±179.84) s,respectively.There was a statistically significant difference between the two groups (P<0.05). There was no statistically significant difference in the number of intraoperative blood loss and intraoperative lymph node dissections between the two groups (P>0.05).There was no statistically significant difference in the levels of maximal expiratory flow (PEF),forced expiratory volume in one second (FEV-1), and FEV-1/ forced vital capacity (FVC) between the two groups before the operation and one month after the operation (P>0.05).The Visual Analogue Scale (VAS) scores of the observation group at 12 hours, 48 hours and 72 hours after the operation were (3.25±0.46) points, (2.13±0.35) points and (1.02±0.24) points respectively. The control groups were (4.11±0.59) points, (2.98±0.42) points, and (1.73±0.30) points,respectively. There was a statistically significant difference between the two groups (P<0.05). There was no statistically significant difference in the scores of negative and positive items between the two groups before the operation and one month after the operation (P>0.05). There was no statistically significant difference in the total incidence of complications between the two groups (P>0.05).Conclusion The modified dilatation collapse method and ICG fluorescence reverse staining method have no significant effects on lung function and complications in patients with stage Ⅰ lung cancer,and both can improve the quality of life.Compared with the modified dilatation collapse method,ICG fluorescence reverse staining method can shorten the plane exposure time between segments and the operation time,promote postoperative rehabilitation and alleviate postoperative pain.

Key words: indocyanine green fluorescence reverse staining method, 3D video-assisted thoracoscopic segmentectomy, improved expansion collapse method, Stage Ⅰ lung cancer, quality of life, complications, lung function