吲哚菁绿 (ICG) 荧光在中低收入国家 (LMIC) 医院结直肠手术吻合口边缘血管性评估中的应用。

Q4 Medicine Acta Medica Philippina Pub Date : 2024-09-13 eCollection Date: 2024-01-01 DOI:10.47895/amp.v58i16.7057
Michael Geoffrey L Lim, Marc Paul J Lopez, Mark Augustine S Onglao, Hermogenes J Monroy, Marie Dione P Sacdalan
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引用次数: 0

摘要

背景和目的:吲哚菁绿(ICG)在外科领域的用途之一是评估结直肠手术的吻合口边缘。这一点尤为重要,因为荧光成像可帮助检测血管受损情况,使外科医生能够改变切除边缘,从而减少吻合口漏的机会。迄今为止,还没有在本地使用荧光成像的研究。本研究旨在确定使用 ICG 是否能安全地识别左侧结肠或直肠手术患者的切除边缘是否有良好的血管,从而降低吻合口漏的发生率:研究人员通过回顾性研究设计,收集了接受左侧结肠或直肠手术患者的数据。方法:研究人员通过回顾性研究设计收集了接受左侧结肠或直肠手术的患者数据,并将其分为使用 ICG 和未使用 ICG 两组,分析了吻合口漏率的对比数据:结果:86 位患者的特征、肿瘤分期和手术方式相似,但两组患者的吻合口漏率均高于对照组。使用 ICG 的患者在最初住院期间和术后 30 天发现的吻合口漏率均低于未使用 ICG 的患者(分别为 p=0.035 和 p=0.047):ICG荧光成像可降低结直肠手术患者的吻合口漏率。
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Indocyanine Green (ICG) Fluorescence in the Assessment of Vascularity of Anastomotic Margins in Colorectal Surgery in a Lower Middle-Income Country (LMIC) Hospital.

Background and objective: One of the uses of indocyanine green (ICG) in the surgical field is the evaluation of the anastomotic margins in colorectal surgery. This is of particular importance because fluorescence imaging may aid in detecting vascular compromise, allowing the surgeon to change the resection margin thereby decreasing the chance of an anastomotic leak. To date, there has been no study with its use locally. This study aimed to determine whether the use of ICG can safely identify if the margins of resection are well-vascularized in patients undergoing left-sided colon or rectal surgery, which in turn may reduce anastomotic leak rates.

Methods: Through a retrospective study design, the investigators gathered data of patients who underwent left-sided colon or rectal surgery. The groups were divided into those with and without the use of ICG and a comparative data on the anastomotic leak rates were analyzed.

Results: Eighty-six (86) patients with similar patient characteristics, tumor staging, and surgical approach were compared. Both the leak rates identified during the initial hospital stay and at 30 days post-operatively were lower in those where ICG was used (p=0.035, p=0.047, respectively) than those where ICG was not used.

Conclusion: ICG fluorescence imaging may reduce the anastomotic leak rates in patients undergoing colorectal surgery.

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Acta Medica Philippina
Acta Medica Philippina Medicine-Medicine (all)
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