Mrugała Maja, Fiutowski Marek, Nowak Krzysztof, Borowiec Zofia, Kasperski Mariusz, Bek Wiktor, Machnicka-Rusek Aneta, Milnerowicz-Nabzdyk Ewa
Clinical Department of Oncological Gynecology, University of Opole, 45-401 Opole, Poland.
J Clin Med. 2024 Sep 13;13(18):5425. doi: 10.3390/jcm13185425.
: This study aimed to evaluate the effectiveness of using indocyanine green (ICG) for assessing ureteral vascularity to reduce ureteral complications in patients undergoing extended hysterectomy for deep endometriosis or oncological indications. : A retrospective-prospective cohort study was conducted at the Centre of Gynecology in Opole, Poland, involving 555 patients who underwent hysterectomy from 2020 to 2023. Patients were categorized based on the Querleu-Morrow classification. ICG was used intraoperatively for vascular assessment in patients with deep endometriosis undergoing wide ureter dissection typical of Type C hysterectomy. : Ureteral complications occurred in 12 (2.2%) patients, with a significantly lower complication rate in those who underwent ICG testing (1.7%) compared to those who did not (22.7%, = 0.001). Prophylactic double-J stenting further reduced the risk of complications. : The use of ICG for intraoperative assessment of ureteral vascularity significantly reduces the risk of ureteral complications in complex hysterectomies. Further studies are needed to confirm these findings.
本研究旨在评估使用吲哚菁绿（ICG）评估输尿管血管情况，以降低因深部子宫内膜异位症或肿瘤适应证接受广泛性子宫切除术患者输尿管并发症的有效性。
在波兰奥波莱妇科中心进行了一项回顾性-前瞻性队列研究，纳入了2020年至2023年期间接受子宫切除术的555例患者。患者根据Querleu-Morrow分类进行分组。ICG在术中用于对因深部子宫内膜异位症接受C型子宫切除术典型的广泛输尿管解剖的患者进行血管评估。
12例（2.2%）患者发生输尿管并发症，接受ICG检测的患者并发症发生率（1.7%）显著低于未接受检测的患者（22.7%，P = 0.001）。预防性双J管置入进一步降低了并发症风险。
术中使用ICG评估输尿管血管情况可显著降低复杂子宫切除术中输尿管并发症的风险。需要进一步研究来证实这些发现。
