Chen Dinghang, Lin Ye, Xu Hui, Chen Shuchen, Hong Zhinuan, Kang Mingqiang
Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China; Key Laboratory of Cardio-Thoracic Surgery(Fujian Medical University), Fujian Province University, Fuzhou, China; Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China.
Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China; Key Laboratory of Cardio-Thoracic Surgery(Fujian Medical University), Fujian Province University, Fuzhou, China; Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China.
Asian J Surg. 2024 Aug 28. doi: 10.1016/j.asjsur.2024.07.200.
To investigate whether the application of intravenous indocyanine green fluorescence imaging(ICG-FI) had advantage in intersegmental plane visualization and perioperative outcome than using traditional inflation-deflation method(control group) in thoracoscopic segmentectomy. We searched PubMed, Embase, Cochrane Library, EMBASE, Wanfang Database, VIP Database, and CNKI Database to include comparative studies focusing on the comparisons of ICG-FI and control, up to December 2022. We used standard mean differences (SMD, continuous variables) or risk ratios (RR, categorical variables) with their corresponding 95 % confidence interval (CI) were used to assess pooled effects. This analysis was conducted according to the PRISMA guideline. Total, seven published studies with 905 patients (ICG-FI group n = 428, control group n = 477) were included for further analysis. The ICG-FI group was significantly associated with less bleeding during the surgery (SMD = -0.23,95 % CI: -0.08∼-0.38, P < 0.05), shorter surgery time (SMD = -0.87, 95 % CI: -1.75∼-0.17, P < 0.05) and intersegmental boundary line (IBL) presentation time (SMD = -4.50, 95 % CI: -4.97∼-4.07, P < 0.01). The ICG-FI group had shorter postoperative hospitalization time (SMD = -0.18, 95 % CI: -0.34∼-0.03), P < 0.05), and the drainage duration (SMD = -0.18, 95 % CI: -0.34∼-0.03,P < 0.05) than that in the control group. The ICG-FI group also showed the less postoperative complications (RR = 0.75, 95 % CI: 0.64-0.88). There were no significant differences in the number of lymph node resection. No significant publication bias were found in this analysis. Compared with inflation-deflation method, application of ICG-FI in thoracoscopic segmentectomy could reduce operation time, IBL presentation time, length of hospital stay, intraoperative blood loss, and overall complication incidence.
为研究在胸腔镜肺段切除术中，静脉注射吲哚菁绿荧光成像（ICG-FI）在节段间平面可视化及围手术期结局方面是否比传统的膨胀-萎陷法（对照组）更具优势。我们检索了PubMed、Embase、Cochrane图书馆、EMBASE、万方数据库、维普数据库和中国知网数据库，纳入截至2022年12月聚焦于ICG-FI与对照组比较的对比研究。我们使用标准均数差（SMD，连续变量）或风险比（RR，分类变量）及其相应的95%置信区间（CI）来评估合并效应。本分析按照PRISMA指南进行。总共纳入7项已发表研究，共905例患者（ICG-FI组n = 428，对照组n = 477）进行进一步分析。ICG-FI组在手术期间出血明显更少（SMD = -0.23，95%CI：-0.08∼-0.38，P < 0.05），手术时间更短（SMD = -0.87，95%CI：-1.75∼-0.17，P < 0.05）以及节段间边界线（IBL）显示时间更短（SMD = -4.50，95%CI：-4.97∼-4.07，P < 0.01）。ICG-FI组术后住院时间更短（SMD = -0.18，95%CI：-0.34∼-0.03，P < 0.05），引流持续时间也更短（SMD = -0.18，95%CI：-0.34∼-0.03，P < 0.05）。ICG-FI组术后并发症也更少（RR = 0.75，95%CI：0.64 - 0.88）。淋巴结切除数量无显著差异。本分析未发现显著的发表偏倚。与膨胀-萎陷法相比，ICG-FI在胸腔镜肺段切除术中的应用可减少手术时间、IBL显示时间、住院时间、术中失血及总体并发症发生率。
