Indocyanine green fluorescence angiography for bowel anastomosis assessment in ovarian cancer surgery.

IF 4.7 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Stephanie J Gill, Elise M Yates, Christian Braun, Kyra Fischer, Maria Clara Santia, Julia H Gelissen, Thomas Bartl, Manel Montesinos-Albert, Matteo Marchetti, Pedro T Ramirez
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引用次数: 0

Abstract

Optimizing bowel anastomotic integrity is a key consideration in ovarian cancer cytoreductive surgery, as anastomotic complications can significantly impact postoperative recovery and delay systemic treatment. Conventional assessment techniques like visual inspection and palpation are inherently subjective and may not consistently predict the likelihood of anastomotic leakage. Due to the serious consequences of anastomotic failure and the impact of diverting ostomies, there is growing interest in fluorescence-based technologies to enhance the diagnostic accuracy of anastomoses and support more informed intraoperative decision-making. Indocyanine green fluorescence angiography (ICG-FA) has emerged as a promising tool for improving the accuracy of bowel perfusion at the time of surgery. While widely adopted in general surgery, its use in gynecologic oncology is still growing and has not yet been established as the standard of care. By allowing surgeons to assess perfusion intraoperatively, ICG-FA may help reduce anastomotic leaks and decrease the need for diverting ostomies, with the goal of improving patient outcomes and quality of life. While early evidence indicates that ICG-FA is a safe and feasible tool in ovarian cancer surgery, additional research is required to develop standardized protocols and evaluate its clinical significance and long-term benefits. This review provides a technical overview, examines the current evidence surrounding ICG-FA in gynecologic oncology, explores its potential advantages and limitations, and highlights future directions for research in fluorescence-guided bowel anastomosis assessment.

吲哚菁绿荧光血管造影对卵巢癌手术中肠吻合的评价。
优化肠吻合口完整性是卵巢癌细胞减少手术的关键考虑因素,因为吻合口并发症会显著影响术后恢复并延迟全身治疗。传统的评估技术,如目视检查和触诊,本质上是主观的,可能无法始终如一地预测吻合口瘘的可能性。由于吻合口失败的严重后果和转移造口的影响,人们越来越关注基于荧光的技术,以提高吻合口的诊断准确性,并支持更明智的术中决策。吲哚菁绿荧光血管造影(ICG-FA)已成为提高手术时肠灌注准确性的一种有前途的工具。虽然广泛应用于普通外科,但其在妇科肿瘤中的应用仍在增长,尚未确立为标准的护理。通过允许外科医生在术中评估灌注,ICG-FA可能有助于减少吻合口泄漏,减少转移造口的需要,以改善患者的预后和生活质量。虽然早期证据表明ICG-FA在卵巢癌手术中是一种安全可行的工具,但需要进一步的研究来制定标准化的方案并评估其临床意义和长期益处。本文综述了技术概况,检查了目前关于妇科肿瘤ICG-FA的证据,探讨了其潜在的优势和局限性,并强调了荧光引导肠吻合评估的未来研究方向。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.60
自引率
10.40%
发文量
280
审稿时长
3-6 weeks
期刊介绍: The International Journal of Gynecological Cancer, the official journal of the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology, is the primary educational and informational publication for topics relevant to detection, prevention, diagnosis, and treatment of gynecologic malignancies. IJGC emphasizes a multidisciplinary approach, and includes original research, reviews, and video articles. The audience consists of gynecologists, medical oncologists, radiation oncologists, radiologists, pathologists, and research scientists with a special interest in gynecological oncology.
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