Indocyanine Green-Enhanced Colorectal Surgery—between Being Superfluous and Being a Game-Changer
Nowadays, surgical innovations incorporate new technological conquests and must be validated by evidence-based medicine. The use of augmented reality-assisted indocyanine green (ICG) fluorescence has generated a myriad of intraoperative applications such as demonstration of key anatomical landmarks,...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-09-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/10/10/742 |
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| author | Catalin Alius Corneliu Tudor Cristinel Dumitru Badiu Ana Maria Dascalu Catalin Gabriel Smarandache Alexandru Dan Sabau Ciprian Tanasescu Simona Andreea Balasescu Dragos Serban |
| author_facet | Catalin Alius Corneliu Tudor Cristinel Dumitru Badiu Ana Maria Dascalu Catalin Gabriel Smarandache Alexandru Dan Sabau Ciprian Tanasescu Simona Andreea Balasescu Dragos Serban |
| author_sort | Catalin Alius |
| collection | DOAJ |
| description | Nowadays, surgical innovations incorporate new technological conquests and must be validated by evidence-based medicine. The use of augmented reality-assisted indocyanine green (ICG) fluorescence has generated a myriad of intraoperative applications such as demonstration of key anatomical landmarks, sentinel lymph nodes, and real-time assessment of local blood flow. This paper presents a systematic review of the clinical evidence regarding the applications of ICG near-infrared (NIR) fluorescence in colorectal surgery. After we removed duplicate publications and screened for eligibility, a total of 36 articles were evaluated: 23 on perfusion assessment, 10 on lymph node mapping, and 3 on intraoperative identification of ureters. Lack of homogenous studies, low statistical power, and confounding evidence were found to be common amongst publications supporting the use of ICG in colorectal surgery, raising concerns over this seductive technique′s cost efficiency and redundancy. The compiled data showed that ICG NIR fluorescence may be a game-changer in particular situations, as proven for low colorectal anastomosis or lateral pelvic lymph node dissection, but it remains controversial for routine use and sentinel lymph node assessment. Further randomized studies are needed to confirm these conclusions. Future research directions include tumor-targeted fluorescence imaging and digital software for quantitative evaluation of fluorescence. |
| first_indexed | 2024-03-10T16:05:02Z |
| format | Article |
| id | doaj.art-bf27f228a88247b5a11ee3517a43c24c |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T16:05:02Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-bf27f228a88247b5a11ee3517a43c24c2023-11-20T14:58:46ZengMDPI AGDiagnostics2075-44182020-09-01101074210.3390/diagnostics10100742Indocyanine Green-Enhanced Colorectal Surgery—between Being Superfluous and Being a Game-ChangerCatalin Alius0Corneliu Tudor1Cristinel Dumitru Badiu2Ana Maria Dascalu3Catalin Gabriel Smarandache4Alexandru Dan Sabau5Ciprian Tanasescu6Simona Andreea Balasescu7Dragos Serban8IVth Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, RomaniaIVth Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, RomaniaFaculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020011 Bucharest, RomaniaIVth Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, RomaniaIVth Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, RomaniaIIIrd Department of Surgery, Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, RomaniaIIIrd Department of Surgery, Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, RomaniaIVth Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, RomaniaIVth Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, RomaniaNowadays, surgical innovations incorporate new technological conquests and must be validated by evidence-based medicine. The use of augmented reality-assisted indocyanine green (ICG) fluorescence has generated a myriad of intraoperative applications such as demonstration of key anatomical landmarks, sentinel lymph nodes, and real-time assessment of local blood flow. This paper presents a systematic review of the clinical evidence regarding the applications of ICG near-infrared (NIR) fluorescence in colorectal surgery. After we removed duplicate publications and screened for eligibility, a total of 36 articles were evaluated: 23 on perfusion assessment, 10 on lymph node mapping, and 3 on intraoperative identification of ureters. Lack of homogenous studies, low statistical power, and confounding evidence were found to be common amongst publications supporting the use of ICG in colorectal surgery, raising concerns over this seductive technique′s cost efficiency and redundancy. The compiled data showed that ICG NIR fluorescence may be a game-changer in particular situations, as proven for low colorectal anastomosis or lateral pelvic lymph node dissection, but it remains controversial for routine use and sentinel lymph node assessment. Further randomized studies are needed to confirm these conclusions. Future research directions include tumor-targeted fluorescence imaging and digital software for quantitative evaluation of fluorescence.https://www.mdpi.com/2075-4418/10/10/742indocyanine greennear-infrared (NIR) fluorescencecolorectal surgeryanastomotic leakslymph node mapping |
| spellingShingle | Catalin Alius Corneliu Tudor Cristinel Dumitru Badiu Ana Maria Dascalu Catalin Gabriel Smarandache Alexandru Dan Sabau Ciprian Tanasescu Simona Andreea Balasescu Dragos Serban Indocyanine Green-Enhanced Colorectal Surgery—between Being Superfluous and Being a Game-Changer Diagnostics indocyanine green near-infrared (NIR) fluorescence colorectal surgery anastomotic leaks lymph node mapping |
| title | Indocyanine Green-Enhanced Colorectal Surgery—between Being Superfluous and Being a Game-Changer |
| title_full | Indocyanine Green-Enhanced Colorectal Surgery—between Being Superfluous and Being a Game-Changer |
| title_fullStr | Indocyanine Green-Enhanced Colorectal Surgery—between Being Superfluous and Being a Game-Changer |
| title_full_unstemmed | Indocyanine Green-Enhanced Colorectal Surgery—between Being Superfluous and Being a Game-Changer |
| title_short | Indocyanine Green-Enhanced Colorectal Surgery—between Being Superfluous and Being a Game-Changer |
| title_sort | indocyanine green enhanced colorectal surgery between being superfluous and being a game changer |
| topic | indocyanine green near-infrared (NIR) fluorescence colorectal surgery anastomotic leaks lymph node mapping |
| url | https://www.mdpi.com/2075-4418/10/10/742 |
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