Fransvea Pietro, Miccini Michelangelo, Rondelli Fabio, Brisinda Giuseppe, Costa Alessandro, Garbarino Giovanni Maria, Costa Gianluca
Emergency Surgery and Trauma, Fondazione Policlinico Universitario "A. Gemelli" IRCCS Roma, Catholic University of Sacred Heart, 00136 Rome, Italy.
Department of Surgery, Sapienza University of Rome, 00185 Rome, Italy.
J Clin Med. 2024 Aug 19;13(16):4895. doi: 10.3390/jcm13164895.
Indocyanine green (ICG) fluorescence imaging has revolutionized surgical practice across various medical and surgical specialties. This article reviews the clinical applications of ICG in abdominal, urological, thoracic, and gynecological surgery. ICG fluorescence imaging has been widely adopted in general surgery for various applications, including perfusion assessment, intraoperative visualization of the ureter, and tumor localization. It is particularly valuable in evaluating anastomotic leaks and aiding in precise tumor resection during minimally invasive surgeries. Studies have shown mixed results on its effectiveness in reducing anastomotic leak rates, highlighting the need for further research. In thoracic surgery, ICG facilitates the identification and resection of pulmonary bullae, as well as the precise localization of pulmonary nodules during video-assisted surgery. In urology, ICG aids in localizing renal tumors and guiding selective arterial occlusion during partial nephrectomy. Its role in identifying the lymphatic pathway in prostate cancer and sentinel lymph node biopsy in gynecological cancer is also discussed. Despite its benefits, the use of ICG fluorescence faces challenges such as limited tissue penetration, the potential for false results, a lack of standardized protocols, and high equipment costs. Nonetheless, it remains a powerful tool that could improve surgical outcomes.
吲哚菁绿（ICG）荧光成像彻底改变了各个医学和外科专业的手术实践。本文综述了ICG在腹部、泌尿外科、胸科和妇科手术中的临床应用。ICG荧光成像已在普通外科广泛应用于各种用途，包括灌注评估、输尿管术中可视化以及肿瘤定位。它在评估吻合口漏以及在微创手术中辅助精确肿瘤切除方面特别有价值。研究表明，其在降低吻合口漏发生率方面的有效性结果不一，凸显了进一步研究的必要性。在胸外科手术中，ICG有助于肺大疱的识别和切除，以及在电视辅助手术中肺结节的精确定位。在泌尿外科，ICG有助于肾肿瘤的定位，并在部分肾切除术中指导选择性动脉闭塞。还讨论了其在识别前列腺癌淋巴途径和妇科癌症前哨淋巴结活检中的作用。尽管有诸多益处，但ICG荧光的使用面临着一些挑战，如组织穿透有限、可能出现假结果、缺乏标准化方案以及设备成本高昂。尽管如此，它仍然是一个可以改善手术效果的强大工具。
