Department of General and Oncological Surgery, Voivodeship Specialist Hospital, 1 Hubalczykow Str. 76-200, Slupsk, Poland.
Department of General, Minimally Invasive and Elderly Surgery, University of Warmia and Mazury in Olsztyn, Niepodleglosci 44 Str., 10-045, Olsztyn, Poland.
Langenbecks Arch Surg. 2023 May 30;408(1):216. doi: 10.1007/s00423-023-02955-9.
This review aims to explore and summarise current knowledge of indocyanine green (ICG) fluorescence application in metabolic and bariatric surgery (MBS) and assess its potential in improving patient safety.
The review was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Evidence from PubMed, ScienceDirect and Ovid MEDLINE databases was independently screened in October 2022. The primary information and outcomes were the type of fluorescence application with potential patient benefit and the complication rate. The secondary outcomes consisted of the kind of dye, the application protocol, and the equipment used.
Thirteen publications were included, with six prospective observational studies, five case reports and two retrospective cohort studies and involved a total of 424 patients. The publications were categorized into four groups based on the method of fluorescence application. Sixty-six percent of the cases used fluorescence for LSG, 32.3% used it for RYGB, 1.2% for revisional surgery, 0.2% during removal of an adjustable gastric band, and 0.2% for LSG combined with Rossetti fundoplication. ICG was used on its own in the majority of studies, although in one case, it was used in combination with methylene blue. ICG administration protocols varied significantly. Complications occurred in three patients (0.71%): leaks were diagnosed in two cases, and one patient required a blood transfusion.
The most popular type of use is intraoperative assessment of the blood supply. ICG application may reduce the risk of complications, with potential benefits in detecting ischemia and leaks, searching for bleeding in areas inaccessible to endoscopy, and non-invasive hepatopathy evaluation.
本综述旨在探讨和总结吲哚菁绿（ICG）荧光在代谢和减重手术（MBS）中的应用知识，并评估其在提高患者安全性方面的潜力。
根据系统评价和荟萃分析的首选报告项目（PRISMA）建议准备综述。2022 年 10 月，独立筛选了来自 PubMed、ScienceDirect 和 Ovid MEDLINE 数据库的证据。主要信息和结果是具有潜在患者获益的荧光应用类型和并发症发生率。次要结果包括染料类型、应用方案和使用的设备。
共纳入 13 篇文献，其中 6 篇为前瞻性观察性研究，5 篇为病例报告，2 篇为回顾性队列研究，共涉及 424 名患者。根据荧光应用方法将文献分为四组。66%的病例用于 LSG，32.3%用于 RYGB，1.2%用于修正手术，0.2%用于可调节胃带去除，0.2%用于 LSG 联合 Rossetti 胃底折叠术。大多数研究单独使用 ICG，但有 1 例与亚甲蓝联合使用。ICG 给药方案差异很大。有 3 名患者（0.71%）发生并发症：2 例诊断为漏液，1 例患者需要输血。
最常见的使用类型是术中评估血液供应。ICG 应用可能降低并发症风险，在检测缺血和漏液、寻找内镜不可及部位的出血以及非侵入性肝病变评估方面具有潜在益处。
