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ICG 给药的时间变化对逆向映射程序中腋窝淋巴结识别的影响。

The Impact of Temporal Variation in ICG Administration on Axillary Node Identification During Reverse Mapping Procedures.

出版信息

Chirurgia (Bucur). 2022 Jun;117(3):305-311. doi: 10.21614/chirurgia.2739.

Abstract

ICG with other tracers can be injected pre and/or per operatively to identify the axillary Lymph Nodes (LN) draining the breast cancer (the SLN nodes) and/or the ipsilateral arm (the ARM nodes). to evaluate the impact on this temporal variable-variation on the identification of these ARM LN. Material and methods: One hundred and nine women, who were scheduled to undergo, either lumpectomy with selective lymphadenectomy (SLN), or mammary surgery (either lumpectomy, or mastectomy) with complete axillary node dissection (CALND) for a histologically proven mammary tumor, had administered the day before the surgery one subcutaneous injection of ICG in the first interdigital space of the ipsilateral hand (pre-op subgroup (SLN=28 and CALND=15), or the same day as the surgery (per op subgroup (SLN=26 and CALND= 20). The fluorescent characteristics of the SLN and/or axillary LN were then analyzed and compared between the two subgroups. Basic characteristics were not significantly different between the pre and per op subgroups. The percentage of patients found with fluorescent SLN (28%), the percentage of patients with fluorescent LN in CALND (74.5%), or the percentage of LN fluorescent in CALND (38.5%) did not differ significantly too. Conclusion: Injection of ICG in the first interdigital space of the hand of operated side performed one day before the surgery or the same day as the surgery has no significant influence in our study on detection of the arm nodes. The timing of ICG injection is an independent variable with no effect on the results; this allows the injection to be performed either the day before the surgery or the day of the surgery.

摘要

ICG 与其他示踪剂可在术前和/或术中注射,以识别引流乳腺癌的腋窝淋巴结 (LN)(SLN 节点)和/或同侧手臂 (LN)(ARM 节点)。评估该时间变量对识别这些 ARM LN 的影响。

材料和方法

109 名女性患者因组织学证实的乳腺肿瘤而计划接受保乳切除术伴选择性淋巴结切除术 (SLN),或乳房手术(保乳术或乳房切除术)伴完全腋窝淋巴结清扫术 (CALND),在手术前一天于同侧手的第一指间皮下注射 ICG(预手术亚组 (SLN=28,CALND=15)),或手术当天 (手术中亚组 (SLN=26,CALND=20)。然后分析和比较两个亚组中 SLN 和/或腋窝 LN 的荧光特征。

基本特征在预手术和手术中亚组之间没有显著差异。荧光 SLN 的患者百分比(28%)、CALND 中荧光 LN 的患者百分比(74.5%)或 CALND 中荧光 LN 的百分比(38.5%)也无显著差异。

结论

在我们的研究中,在手术侧手部第一指间皮下注射 ICG 一天前或手术当天进行,对检测手臂节点没有显著影响。ICG 注射的时间是一个独立变量,对结果没有影响;这允许在手术前一天或手术当天进行注射。

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