Konstantinidis Michael K, Ioannidis Argyrios, Vassiliu Panteleimon, Arkadopoulos Nikolaos, Papanikolaou Ioannis S, Stavridis Konstantinos, Gallo Gaetano, Karagiannis Dimitrios, Chand Manish, Wexner Steven D, Konstantinidis Konstantinos
Department of General, Laparoscopic, Oncologic and Robotic Surgery, Athens Medical Center, Athens, Greece.
Fourth Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.
Front Surg. 2023 Aug 11;10:1258343. doi: 10.3389/fsurg.2023.1258343. eCollection 2023.
To describe the currently available evidence regarding the efficacy and safety of preoperative tumor marking using indocyanine green (ICG) prior to laparoscopic or robotic colorectal resections.
A systematic search for relevant studies was conducted using the following databases: Embase (OVID), MEDLINE® (OVID), APA PsycInfo (OVID), Global Health (OVID) and HMIC Health Management Information Consortium (OVID) through June 2022 reported according to PRISMA 2020 guidelines. Primary outcome was the detection rate of the tumor sites preoperatively marked with ICG. Secondary outcomes were timing of ICG injection in days prior to the operation and technique-related complications.
Eight single center studies, published between 2008 and 2022, were identified yielding a total of 1,061 patients, of whom 696 were preoperatively tattooed with ICG. Injection dosage of diluted ICG ranged from 0.1-1.5 ml. Four studies used the saline test injection method prior to ICG injection. When the marking was placed within one week, the visualization rate was 650/668 (97%), whereas when it was longer than one week, the detection rate was 8/56 (14%). No severe complications were reported.
Preoperative tumor marking using ICG prior to minimally invasive colorectal resections is safe and effective, allowing intraoperative tumor site location when performed up to a week prior to surgery without disturbing the surgical view in potential mild complications.
描述目前关于在腹腔镜或机器人辅助结直肠切除术前使用吲哚菁绿（ICG）进行肿瘤标记的有效性和安全性的现有证据。
根据PRISMA 2020指南，通过以下数据库对相关研究进行系统检索：截至2022年6月的Embase（OVID）、MEDLINE®（OVID）、APA PsycInfo（OVID）、Global Health（OVID）和HMIC健康管理信息联盟（OVID）。主要结局是术前用ICG标记的肿瘤部位的检出率。次要结局是手术前几天ICG注射的时间以及技术相关并发症。
确定了2008年至2022年间发表的8项单中心研究，共纳入1061例患者，其中696例术前用ICG进行了标记。稀释后的ICG注射剂量为0.1 - 1.5毫升。4项研究在ICG注射前采用了盐水试验注射法。当标记在一周内进行时，可视化率为650/668（97%），而当超过一周时，检出率为8/56（14%）。未报告严重并发症。
在微创结直肠切除术前使用ICG进行肿瘤标记是安全有效的，在术前一周内进行可实现术中肿瘤部位定位，且在潜在的轻度并发症中不影响手术视野。
