Kalayarasan Raja, Chandrasekar Murugesan, Sai Krishna Pothugunta, Shanmugam Dasarathan
Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India.
World J Gastrointest Surg. 2023 Dec 27;15(12):2693-2708. doi: 10.4240/wjgs.v15.i12.2693.
Applying indocyanine green (ICG) fluorescence in surgery has created a new dimension of navigation surgery to advance in various disciplines. The research in this field is nascent and fragmented, necessitating academic efforts to gain a comprehensive understanding. The present review aims to integrate diverse perspectives and recent advances in its application in gastrointestinal surgery. The relevant articles were selected by using the appropriate keyword search in PubMed. The angiography and cholangiography property of ICG fluorescence is helpful in various hepatobiliary disorders. In gastroesophageal and colorectal surgery, the lymphangiography and angiography property of ICG is applied to evaluate bowel vascularity and guide lymphadenectomy. The lack of objective parameters to assess ICG fluorescence has been the primary limitation when ICG is used to evaluate bowel perfusion. The optimum dose and timing of ICG administration need to be standardized in some new application areas in gastrointestinal surgery. Binding tumor-specific ligands with fluorophores can potentially widen the fluorescence application to detect primary and metastatic gastrointestinal tumors. The narrative review outlines prior contributions, limitations, and research opportunities for future studies across gastrointestinal sub-specialty. The findings of the present review would be helpful for scholars and practitioners to explore and progress in this exciting domain of gastrointestinal surgery.
在手术中应用吲哚菁绿(ICG)荧光开创了导航手术的新维度,推动了各学科的发展。该领域的研究尚处于起步阶段且较为零散,需要学术界做出努力以获得全面的理解。本综述旨在整合其在胃肠外科应用中的不同观点和最新进展。通过在PubMed中使用适当的关键词搜索来选择相关文章。ICG荧光的血管造影和胆管造影特性有助于诊断各种肝胆疾病。在胃食管和结直肠手术中,ICG的淋巴管造影和血管造影特性可用于评估肠道血管情况并指导淋巴结清扫。当ICG用于评估肠道灌注时,缺乏评估ICG荧光的客观参数一直是主要限制因素。在胃肠外科的一些新应用领域,ICG给药的最佳剂量和时机需要标准化。将肿瘤特异性配体与荧光团结合可能会扩大荧光在检测原发性和转移性胃肠道肿瘤方面的应用。本叙述性综述概述了胃肠亚专业先前的贡献、局限性以及未来研究的机会。本综述的结果将有助于学者和从业者在这个令人兴奋的胃肠外科领域进行探索和取得进展。