Szavay Philipp O, Bondoc Alex, Esposito Ciro, Goldstein Seth D, Harms Marc, Kowalewski Grzegorz, Lautz Timothy B, Lopez Manuel, Pachl Max, Pandya Samir, Piché Nelson, Rothenberg Steven S, Ruiterkamp Jetske, Scholz Stefan, Zendejas Benjamin, Rentea Rebecca M
Department of Pediatric Surgery, Lucerne Children's Hospital, Lucerne, Switzerland.
Department of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
J Pediatr Surg. 2024 Nov;59(11):161657. doi: 10.1016/j.jpedsurg.2024.07.042. Epub 2024 Jul 30.
Indocyanine Green Fluorescence (ICG-F)- guided surgery is becoming an increasingly helpful tool in pediatric surgical care. This consensus statement investigates the utility of ICG-F in various pediatric surgical applications, primarily focusing on its evidence base, safety, indications, use across different surgical specialties and dosing strategies. The aim is to establish an international consensus for ICG-F use in pediatric surgery.
An international panel of 15 pediatric surgeons from 9 countries was assembled. The structured process consisted of a rapid scoping review, iterative discussion sessions, mixed-methods studies with key stakeholders, and voting rounds on individual statements to create draft consensus statements.
100 articles were identified during the review and summarized by application. Based on this condensed evidence, consensus statements were generated after 3 iterative rounds of anonymous voting. Key areas of agreement were quality of evidence, the safety of ICG, pediatric surgical indications, utilization per surgical specialty, and dosing of ICG.
This consensus statement aims to guide healthcare professionals in managing ICG-F use in pediatric surgical cases based on the best available evidence, key stakeholder consultation, and expert opinions. Despite ICG-F's promising potential, the need for higher-quality evidence, prospective trials, and safety studies is underscored. The consensus also provides a framework for pediatric surgeons to utilize ICG-F effectively.
III.
吲哚菁绿荧光(ICG-F)引导手术正逐渐成为小儿外科治疗中一项越来越有用的工具。本共识声明探讨了ICG-F在各种小儿外科应用中的效用,主要关注其证据基础、安全性、适应症、在不同外科专业中的应用以及给药策略。目的是就小儿外科中ICG-F的使用达成国际共识。
组建了一个由来自9个国家的15名小儿外科医生组成的国际专家小组。结构化过程包括快速范围审查、迭代讨论会议、与关键利益相关者的混合方法研究以及对个别声明的投票轮次,以制定共识声明草案。
在审查过程中识别出100篇文章,并按应用进行了总结。基于这些浓缩的证据,经过三轮匿名投票迭代后生成了共识声明。达成一致的关键领域包括证据质量、ICG的安全性、小儿外科适应症、各外科专业的应用情况以及ICG的给药。
本共识声明旨在根据现有最佳证据、关键利益相关者咨询和专家意见,指导医疗保健专业人员在小儿外科病例中管理ICG-F的使用。尽管ICG-F具有广阔前景,但强调了对更高质量证据、前瞻性试验和安全性研究的需求。该共识还为小儿外科医生有效利用ICG-F提供了一个框架。
III级。