Wenzhi Xu , Jianqiong Li , Saihua Chen , Jiaren Zhang , Xueyuan Chen , Jianhua Yang
{"title":"吲哚青绿增强近红外荧光引导成像在早期子宫内膜癌症患者腹腔镜淋巴结清扫中的优越性：一项回顾性队列研究","authors":"Wenzhi Xu , Jianqiong Li , Saihua Chen , Jiaren Zhang , Xueyuan Chen , Jianhua Yang","doi":"10.1016/j.lers.2023.07.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Laparoscopic pelvic lymph node dissection (LPND), which is an effective therapy for endometrial cancer, is challenging because of the complexity of the procedure and the occurrence of postoperative complications. This study aimed to explore whether indocyanine green (ICG)-enhanced near-infrared (NIR) fluorescence-guided LPND is superior to LPND in the context of early-stage endometrial carcinoma.</p></div><div><h3>Methods</h3><p>In this retrospective study, we included the medical records of 190 patients with early-stage endometrioid adenocarcinoma who underwent LPND at the Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine between January 2019 and January 2021. Depending on whether ICG-enhanced NIR fluorescence guidance was used, the patients were assigned to the ICG group or non-ICG group. Patients were followed-up for one year after surgery. Data on demographic characteristics, pathological results, operative outcomes, and complications were collected and analyzed.</p></div><div><h3>Results</h3><p>The baseline characteristics were comparable between the ICG group and non-ICG group, including age, BMI, pregnancy history, and preoperative hemoglobin. For surgical outcomes, the patients in ICG group had significantly lower intraoperative blood loss (50 mL vs. 120 mL, <em>p</em> < 0.001), less postoperative pelvic drainage time (4.14 ± 1.44 d vs. 5.70 ± 1.89 d, <em>p</em> = 0.001), shorter duration of hospital stay (5.26 ± 1.41 d vs. 7.37 ± 1.85 d, <em>p</em> = 0.003), higher number of positive pelvic lymph nodes (PLNs) (1 vs. 0, <em>p</em> = 0.003), and more PLN-positive cases (16.0% vs. 3.6%, <em>p</em> = 0.003) than the patients in non-ICG group. However, no significant differences were noted in blood transfusion requirement, operative time, hemoglobin level decreases, number of PLNs harvested, or the presence of lymphocysts between the two groups.</p></div><div><h3>Conclusion</h3><p>Our study showed that ICG-enhanced NIR fluorescence-guided operation may improve the accuracy and safety of LPND.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"6 3","pages":"Pages 103-108"},"PeriodicalIF":0.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Superiority of indocyanine green-enhanced near-infrared fluorescence-guided imaging for laparoscopic lymph node dissection in patients with early-stage endometrial cancer: A retrospective cohort study\",\"authors\":\"Wenzhi Xu , Jianqiong Li , Saihua Chen , Jiaren Zhang , Xueyuan Chen , Jianhua Yang\",\"doi\":\"10.1016/j.lers.2023.07.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>Laparoscopic pelvic lymph node dissection (LPND), which is an effective therapy for endometrial cancer, is challenging because of the complexity of the procedure and the occurrence of postoperative complications. This study aimed to explore whether indocyanine green (ICG)-enhanced near-infrared (NIR) fluorescence-guided LPND is superior to LPND in the context of early-stage endometrial carcinoma.</p></div><div><h3>Methods</h3><p>In this retrospective study, we included the medical records of 190 patients with early-stage endometrioid adenocarcinoma who underwent LPND at the Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine between January 2019 and January 2021. Depending on whether ICG-enhanced NIR fluorescence guidance was used, the patients were assigned to the ICG group or non-ICG group. Patients were followed-up for one year after surgery. Data on demographic characteristics, pathological results, operative outcomes, and complications were collected and analyzed.</p></div><div><h3>Results</h3><p>The baseline characteristics were comparable between the ICG group and non-ICG group, including age, BMI, pregnancy history, and preoperative hemoglobin. For surgical outcomes, the patients in ICG group had significantly lower intraoperative blood loss (50 mL vs. 120 mL, <em>p</em> < 0.001), less postoperative pelvic drainage time (4.14 ± 1.44 d vs. 5.70 ± 1.89 d, <em>p</em> = 0.001), shorter duration of hospital stay (5.26 ± 1.41 d vs. 7.37 ± 1.85 d, <em>p</em> = 0.003), higher number of positive pelvic lymph nodes (PLNs) (1 vs. 0, <em>p</em> = 0.003), and more PLN-positive cases (16.0% vs. 3.6%, <em>p</em> = 0.003) than the patients in non-ICG group. However, no significant differences were noted in blood transfusion requirement, operative time, hemoglobin level decreases, number of PLNs harvested, or the presence of lymphocysts between the two groups.</p></div><div><h3>Conclusion</h3><p>Our study showed that ICG-enhanced NIR fluorescence-guided operation may improve the accuracy and safety of LPND.</p></div>\",\"PeriodicalId\":32893,\"journal\":{\"name\":\"Laparoscopic Endoscopic and Robotic Surgery\",\"volume\":\"6 3\",\"pages\":\"Pages 103-108\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Laparoscopic Endoscopic and Robotic Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2468900923000415\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laparoscopic Endoscopic and Robotic Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468900923000415","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的腹腔镜盆腔淋巴结清扫术（LPND）是治疗癌症的有效方法，但由于其操作的复杂性和术后并发症的发生，具有一定的挑战性。本研究旨在探讨吲哚菁绿（ICG）增强的近红外（NIR）荧光引导的LPND在早期子宫内膜癌中是否优于LPND。方法在这项回顾性研究中，我们纳入了2019年1月至2021年1月在浙江大学医学院邵逸夫医院妇产科接受LPND的190例早期子宫内膜样腺癌患者的病历。根据是否使用ICG增强近红外荧光引导，将患者分为ICG组或非ICG组。患者术后随访一年。收集并分析人口统计学特征、病理结果、手术结果和并发症的数据。结果ICG组和非ICG组的基线特征具有可比性，包括年龄、BMI、妊娠史和术前血红蛋白。就手术结果而言，ICG组患者术中失血量显著降低（50 mL vs.120 mL，p＜0.001），术后盆腔引流时间更短（4.14±1.44 d vs.5.70±1.89 d，p＝0.001），住院时间更短（5.26±1.41 d vs.7.37±1.85 d，p=0.003），盆腔淋巴结阳性数更高（1 vs.0，p＝0.003），与非ICG组患者相比，PLN阳性病例更多（16.0%vs.3.6%，p=0.003）。然而，两组在输血要求、手术时间、血红蛋白水平下降、采集的PLN数量或淋巴囊肿的存在方面没有显著差异。结论ICG增强近红外荧光引导操作可提高LPND的准确性和安全性。
Superiority of indocyanine green-enhanced near-infrared fluorescence-guided imaging for laparoscopic lymph node dissection in patients with early-stage endometrial cancer: A retrospective cohort study
Objective
Laparoscopic pelvic lymph node dissection (LPND), which is an effective therapy for endometrial cancer, is challenging because of the complexity of the procedure and the occurrence of postoperative complications. This study aimed to explore whether indocyanine green (ICG)-enhanced near-infrared (NIR) fluorescence-guided LPND is superior to LPND in the context of early-stage endometrial carcinoma.
Methods
In this retrospective study, we included the medical records of 190 patients with early-stage endometrioid adenocarcinoma who underwent LPND at the Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine between January 2019 and January 2021. Depending on whether ICG-enhanced NIR fluorescence guidance was used, the patients were assigned to the ICG group or non-ICG group. Patients were followed-up for one year after surgery. Data on demographic characteristics, pathological results, operative outcomes, and complications were collected and analyzed.
Results
The baseline characteristics were comparable between the ICG group and non-ICG group, including age, BMI, pregnancy history, and preoperative hemoglobin. For surgical outcomes, the patients in ICG group had significantly lower intraoperative blood loss (50 mL vs. 120 mL, p < 0.001), less postoperative pelvic drainage time (4.14 ± 1.44 d vs. 5.70 ± 1.89 d, p = 0.001), shorter duration of hospital stay (5.26 ± 1.41 d vs. 7.37 ± 1.85 d, p = 0.003), higher number of positive pelvic lymph nodes (PLNs) (1 vs. 0, p = 0.003), and more PLN-positive cases (16.0% vs. 3.6%, p = 0.003) than the patients in non-ICG group. However, no significant differences were noted in blood transfusion requirement, operative time, hemoglobin level decreases, number of PLNs harvested, or the presence of lymphocysts between the two groups.
Conclusion
Our study showed that ICG-enhanced NIR fluorescence-guided operation may improve the accuracy and safety of LPND.
期刊介绍：
Laparoscopic, Endoscopic and Robotic Surgery aims to provide an academic exchange platform for minimally invasive surgery at an international level. We seek out and publish the excellent original articles, reviews and editorials as well as exciting new techniques to promote the academic development.
Topics of interests include, but are not limited to:
▪ Minimally invasive clinical research mainly in General Surgery, Thoracic Surgery, Urology, Neurosurgery, Gynecology & Obstetrics, Gastroenterology, Orthopedics, Colorectal Surgery, Otolaryngology, etc.;
▪ Basic research in minimally invasive surgery;
▪ Research of techniques and equipments in minimally invasive surgery, and application of laparoscopy, endoscopy, robot and medical imaging;
▪ Development of medical education in minimally invasive surgery.
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