Karmarkar Rahi, Latour Jos, Hosking Joanne, Aroori Somaiah
Faculty of Health, University Hospitals Plymouth NHS Trust, Plymouth, UK.
Royal Wolverhampton NHS Trust, Wolverhampton, UK.
J Fluoresc. 2024 Dec 7. doi: 10.1007/s10895-024-04022-y.
Indocyanine Green (ICG) fluorescence-guided surgery (I-FIGS) is increasingly being used in hepato-pancreatico-biliary (HPB) surgery. However, the true benefit of I-FIGS, the optimum dosing, and the timing of ICG administration still need to be determined. To conduct future research studies in the above areas, it is essential to understand the current I-FIGS practices among surgeons. This survey investigated the practices and perceptions of I-FIGS in liver surgery among HPB surgeons in the United Kingdom (UK). A survey was sent via email and social media to surgeons from all HPB units in the UK. The survey consisted of 18 questions, covering various aspects such as experience levels, volume of operations, approach to liver resections, ICG dosage, timing of administration, application specifics, camera systems used, and willingness to participate in future trials. The survey was sent to 81 HPB surgeons (working in 25 HPB units) across the UK. The response rate was 70% (57/81 surgeons). 56% of the surgeons reported having the infrastructure for I-FIGS at their hospital. The use of I-FIGS varied in duration and patient volume, with 47% of surgeons reporting its use for less than one year and 53% of surgeons reporting using it in fewer than ten patients. Preferences for the dose and timing of ICG administration also varied, reflecting the absence of standardised guidelines. The Storz camera system emerged as the most used imaging system (42% of surgeons), followed by the Stryker (25.8%). None of the surgeons reported any I-FIGS-related side effects. Ninety-six per cent of surgeons expressed interest in participating in future clinical trials in the field of I-FIGS. The survey highlights that I-FIGS in liver surgery is not widely used in the UK. There are also wide variations in the dosing and timing of ICG administration. Large multi-centre studies are needed to focus on dosing, timing of ICG administration, and establishing its actual role in liver surgery.
吲哚菁绿（ICG）荧光引导手术（I-FIGS）在肝胰胆（HPB）手术中的应用越来越广泛。然而，I-FIGS的真正益处、最佳剂量以及ICG给药时机仍有待确定。为了在上述领域开展未来的研究，了解外科医生目前的I-FIGS实践至关重要。这项调查研究了英国HPB外科医生在肝脏手术中I-FIGS的实践情况和看法。通过电子邮件和社交媒体向英国所有HPB科室的外科医生发送了调查问卷。该调查问卷包含18个问题，涵盖经验水平、手术量、肝切除术方法、ICG剂量、给药时机、应用细节、使用的摄像系统以及参与未来试验的意愿等各个方面。该调查问卷发送给了英国各地81名HPB外科医生（在25个HPB科室工作）。回复率为70%（57/81名外科医生）。56%的外科医生报告称其所在医院具备I-FIGS的基础设施。I-FIGS的使用在持续时间和患者数量方面存在差异，47%的外科医生报告其使用时间不到一年，53%的外科医生报告使用该技术的患者少于10例。ICG给药剂量和时机的偏好也各不相同，这反映出缺乏标准化指南。史托斯摄像系统是使用最多的成像系统（42%的外科医生），其次是史赛克（25.8%）。没有外科医生报告任何与I-FIGS相关的副作用。96%的外科医生表示有兴趣参与I-FIGS领域未来的临床试验。该调查强调，I-FIGS在肝脏手术中在英国并未广泛应用。ICG给药的剂量和时机也存在很大差异。需要开展大型多中心研究，重点关注ICG给药剂量、给药时机，并确定其在肝脏手术中的实际作用。
