Katsimperis Stamatios, Tzelves Lazaros, Bellos Themistoklis, Manolitsis Ioannis, Mourmouris Panagiotis, Kostakopoulos Nikolaos, Pyrgidis Nikolaos, Somani Bhaskar, Papatsoris Athanasios, Skolarikos Andreas
Second Department of Urology, Sismanoglio Hospital, Athens, Greece.
University College of London Hospitals NHS Foundation Trust, London, United Kingdom.
Cent European J Urol. 2024;77(1):15-21. doi: 10.5173/ceju.2023.155. Epub 2024 Jan 8.
The aim of this review was to assess the outcomes of partial nephrectomy using indocyanine green (ICG) regarding ischemia time, positive surgical margins (PSM), estimated blood loss (EBL) and estimated GFR reduction while also suggesting the optimal dosage scheme.
A systematic review was performed using Medline (PubMed), ClinicalTrials.gov, and Cochrane Library (CENTRAL) databases, in concordance with the PRISMA statement. Studies in English regarding the use of indocyanine green in partial nephrectomy were reviewed. Reviews and meta-analyses, editorials, perspectives, and letters to the editors were excluded.
Individual ICG dose was 5 mg in most of the studies. The mean warm ischemia time (WIT) on each study ranged from 11.6 minutes to 27.2 minutes. The reported eGFR reduction ranged from 0% to 15.47%. Lowest mean EBL rate was 48.2 ml and the highest was 347 ml. Positive surgical margin rates were between 0.3% to 11%.
Indocyanine green seems to be a useful tool in partial nephrectomy as it can assist surgeons in identifying tumor and its related vasculature. Thereby, warm ischemia time can be reduced and, in some cases, selective ischemia can be implemented leading to better renal functional preservation.
本综述的目的是评估使用吲哚菁绿（ICG）进行部分肾切除术在缺血时间、手术切缘阳性（PSM）、估计失血量（EBL）和估计肾小球滤过率降低方面的结果，同时提出最佳剂量方案。
按照PRISMA声明，使用Medline（PubMed）、ClinicalTrials.gov和Cochrane图书馆（CENTRAL）数据库进行系统综述。对英文的关于吲哚菁绿在部分肾切除术中应用的研究进行了综述。排除综述和荟萃分析、社论、观点文章以及给编辑的信件。
大多数研究中吲哚菁绿的个体剂量为5毫克。每项研究的平均热缺血时间（WIT）在11.6分钟至27.2分钟之间。报告的估计肾小球滤过率降低范围为0%至15.47%。最低平均EBL率为48.2毫升，最高为347毫升。手术切缘阳性率在0.3%至11%之间。
吲哚菁绿似乎是部分肾切除术中一种有用的工具，因为它可以帮助外科医生识别肿瘤及其相关血管。因此，可以减少热缺血时间，在某些情况下，可以实施选择性缺血，从而更好地保留肾功能。
