Near-Infrared Fluorescence Imaging with Intravenous Indocyanine Green Method in Segmentectomy for Infants with Congenital Pulmonary Airway Malformation.

IF 1.5 3区 医学 Q2 PEDIATRICS European Journal of Pediatric Surgery Pub Date : 2024-10-01 Epub Date: 2023-11-08 DOI:10.1055/a-2206-6702
Jin-Xi Huang, Qiang Chen, Song-Ming Hong, Jun-Jie Hong, Hua Cao
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Abstract

Background:  Video-assisted thoracoscopic surgery is a commonly used procedure for treating congenital pulmonary airway malformation (CPAM) in infants, particularly when performing segmentectomy for segmental lesions. An innovative technique employing near-infrared fluorescence (NIRF) imaging with intravenous indocyanine green (ICG) has been utilized to delineate the intersegmental demarcation during surgery. However, no previous reports have investigated this method's application, specifically in infants. The primary aim of this study was to assess the safety and efficacy of the NIRF imaging with ICG approach in this context.

Methods:  Between January 2021 and April 2022, a total of 19 consecutive segmentectomies were conducted using the NIRF imaging with ICG method to precisely identify the intersegmental plane. The results were concurrently compared with those obtained using the modified inflation-deflation technique. Comprehensive imaging and clinical data were gathered and analyzed to assess the safety and accuracy of the NIRF imaging with ICG approach.

Results:  The study involved infants with a median age of 5.12 months (mean body weight of 8.08 g). All segmentectomies were performed successfully without any ICG-related complications. The mean operating time for the surgeries was 88.47 ± 7.94 minutes. Notably, no intraoperative conversions or significant complications were observed in any of the patients. The average hospital stay after surgery was 4.0 ± 0.82 days. During the follow-up period, extending beyond 1-year of postoperation, all patients exhibited excellent recovery with no cases of recurrence.

Conclusions:  Based on our experience, the NIRF imaging with intravenous ICG method proved to be both safe and effective when performing segmentectomy for infants with CPAM. Low doses of ICG did not hinder the accurate identification of the intersegmental plane.

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静脉吲哚青绿法近红外荧光成像在先天性肺气道畸形婴儿肺段切除术中的应用。
背景:电视胸腔镜手术(VATS)是治疗婴儿先天性肺气道畸形(CPAM)的常用手术,尤其是在对节段性病变进行节段切除时。采用静脉注射吲哚菁绿(ICG)的近红外荧光(NIRF)成像的一种创新技术已被用于描绘手术期间的节段间分界。然而,以前没有任何报告专门研究这种方法在婴儿中的应用。本研究的主要目的是评估在这种情况下使用ICG方法进行NIRF成像的安全性和有效性。方法:在2021年1月至2022年4月期间,共使用ICG方法进行了19次连续的节段切除术,以精确识别节段间平面。同时将结果与使用改进的通货膨胀-通货紧缩技术获得的结果进行了比较。收集并分析了综合的成像和临床数据,以评估ICG方法的NIRF成像的安全性和准确性。结果:该研究涉及中位年龄5.12个月(平均体重8.08g)的婴儿。所有节段切除术均成功进行,没有任何与ICG相关的并发症。平均手术时间为88.47±7.94分钟。值得注意的是,在任何患者中都没有观察到术中转换或重大并发症。术后平均住院时间为4.0±0.82天。在术后一年以上的随访期间,所有患者都表现出良好的恢复,没有复发病例。结论:根据我们的经验,静脉ICG方法的NIRF成像在对患有CPAM的婴儿进行节段切除术时被证明是安全有效的。低剂量的ICG并不妨碍准确识别节段间平面。
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来源期刊
CiteScore
3.90
自引率
5.60%
发文量
66
审稿时长
6-12 weeks
期刊介绍: This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.
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