Shevchenko Irina, Serban Dragos, Dascalu Ana Maria, Tribus Laura, Alius Catalin, Cristea Bogdan Mihai, Suceveanu Andra Iulia, Voiculescu Daniel, Dumitrescu Dan, Bobirca Florin, Suceveanu Adrian Paul, Georgescu Dragos Eugen, Serboiu Crenguta Sorina
Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU.
General Surgery, Emergency University Hospital Bucharest, Bucharest, ROU.
Cureus. 2024 Feb 29;16(2):e55290. doi: 10.7759/cureus.55290. eCollection 2024 Feb.
As laparoscopy gained global popularity in oncologic surgery, the challenge of detecting lymph nodes spurred researchers to explore innovative techniques and approach the situation from a fresh perspective. While many proposed methods have faded into obscurity, the utilization of indocyanine green (ICG) in the surgical treatment of oncologic patients has continued to advance. The immense potential of this dye is widely acknowledged, yet its full extent and limitations in lymphatic mapping for colorectal cancer remain to be precisely determined. This article aims to assess the magnitude of its potential and explore the constraints based on insights from clinical studies published by pioneering researchers. A systematic review of the existing literature, comprising articles in English, was conducted using the Scopus, PubMed, and Springer Link databases. The search employed keywords such as "colorectal cancer" AND/OR "indocyanine green," "fluorescence" AND/OR "lymphatic mapping" AND/OR "lymph nodes." Initially identifying 129 articles, the application of selection criteria narrowed down the pool to 10 articles, which served as the primary sources of data for our review. Despite the absence of a standardized protocol for the application of ICG in colorectal cancer, particularly in the context of lymphatic mapping, the detection rates have exhibited considerable variation across studies. Nevertheless, all authors unanimously regarded this technique as beneficial and promising. Additionally, it is advocated as an adjunctive tool to enhance the accuracy of cancer staging. Near-infrared (NIR)-enhanced surgery holds the promise of transforming the landscape of oncologic surgery, emerging as a valuable tool for surgeons. However, the absence of a standardized technique and the subjective nature of result assessment impose limitations on the potential of this method. Consequently, it can be inferred that the establishment of a universally accepted protocol, encompassing parameters such as dose, concentration, technique, and site of administration of ICG, along with the optimal time needed for fluorescence visualization, would enhance the outcomes. Emphasizing the accurate selection of patients is crucial to prevent the occurrence of false-negative results.
随着腹腔镜手术在肿瘤外科领域在全球范围内日益普及，检测淋巴结的挑战促使研究人员探索创新技术，并从全新角度应对这一情况。尽管许多提出的方法已逐渐被遗忘，但吲哚菁绿（ICG）在肿瘤患者外科治疗中的应用仍在不断发展。这种染料的巨大潜力已得到广泛认可，但其在结直肠癌淋巴绘图中的全部潜力和局限性仍有待精确确定。本文旨在根据开创性研究人员发表的临床研究见解，评估其潜力大小并探索其局限性。使用Scopus、PubMed和Springer Link数据库对现有文献进行了系统综述，这些文献均为英文文章。搜索使用了“结直肠癌”和/或“吲哚菁绿”、“荧光”和/或“淋巴绘图”和/或“淋巴结”等关键词。最初识别出129篇文章，应用选择标准后将范围缩小至10篇文章，这些文章成为我们综述的主要数据来源。尽管在结直肠癌中应用ICG，特别是在淋巴绘图方面，缺乏标准化方案，但各研究中的检测率仍存在显著差异。然而，所有作者一致认为该技术有益且有前景。此外，它被倡导作为一种辅助工具来提高癌症分期的准确性。近红外（NIR）增强手术有望改变肿瘤外科的格局，成为外科医生的一项有价值工具。然而，缺乏标准化技术以及结果评估的主观性限制了该方法的潜力。因此，可以推断，建立一个普遍接受的方案，包括ICG的剂量、浓度、技术、给药部位等参数，以及荧光可视化所需的最佳时间，将改善结果。强调准确选择患者对于防止假阴性结果的出现至关重要。
