Objective:To evaluate the application value of fusion ICG-fluorescence imaging (FIGFI) in laparoscopic anatomical hepatectomy (LAH) for primary liver cancer (PLC).Methods:Clinical data of 70 PLC patients who underwent LAH in the Third People's Hospital Affiliated to Nantong University from March 2018 to December 2021 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 47 patients were male and 23 female, aged from 35 to 76 years, with a median age of 58 years. According to different surgical methods, all patients were divided into the FIGFI-LAH (n=31) and LAH groups (n=39). Preoperative conditions, conversion rate to open surgery, hepatic portal occlusion time, operation time, intraoperative blood loss, postoperative complications, postoperative recurrence and survival were compared between two groups. The positive margin rate was compared by Chi-square test. The survival curve was delineated by Kaplan-Meier method. The 1-, 2- and 3-year recurrence and survival rates were compared by Z test.Results:In the FIGFI-LAH group, 1 case was converted to open surgery, 2 cases in the LAH group. The remaining patients successfully completed the surgery. The positive margin rate in the FIGFI-LAH group was 3%(1/31), significantly lower than 21%(8/39) in the LAH group (χ2=4.607, P<0.05). In the FIGFI-LAH group, the 1-, 2-, 3-year cumulative recurrence rates were 3%, 14%, 22%, and 5%, 17%, 72% in the LAH group, respectively. The 3-year cumulative recurrence rate in the FIGFI-LAH group was significantly lower than that in the LAH group(Z=-5.705, P<0.05). The 1-, 2-, 3-year cumulative survival rates in the FIGFI-LAH group were 100%, 100%, 84%, and 97%, 91% and 53% in the LAH group, respectively. The 3-year cumulative survival rate in the FIGFI-LAH group was significantly higher than that in the LAH group (Z=4.478, P<0.05).Conclusions:It is safe and feasible to apply FIGFI in LAH, which can realize visual display of tumor margin and precise hepatectomy, effectively reduce the positive margin rate and contribute to enhancing the long-term survival rate of PLC patients.
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