First experience on laparoscopic near-infrared fluorescence imaging of hepatic uveal melanoma metastases using indocyanine green.
First experience on laparoscopic near-infrared fluorescence imaging of hepatic uveal melanoma metastases using indocyanine green.
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DOI：
10.1177/1553350614535857
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发表时间：
2015-02
影响因子：
1.5
通讯作者：
Vahrmeijer AL
中科院分区：
文献类型：
--
作者：
Tummers QR;Verbeek FP;Prevoo HA;Braat AE;Baeten CI;Frangioni JV;van de Velde CJ;Vahrmeijer AL
葡萄膜黑色素瘤是成人最常见的原发性眼内肿瘤，高达50%的患者会发生肝转移。完全手术切除这些转移瘤可以提高5年生存率，但只有少数患者符合根治性手术治疗的条件。本研究的目的是在微创手术中引入近红外（NIR）荧光腹腔镜，用于术中识别葡萄膜黑色素瘤肝转移，并在切除过程中使用它提供指导。三名患者诊断为一个孤立的肝转移葡萄膜黑色素瘤。术前24 h静脉注射吲哚菁绿色（ICG）10 mg。近红外荧光腹腔镜用于检测肝脏恶性病变。在所有3例患者中，使用ICG的腹腔镜NIR荧光成像成功识别了葡萄膜黑色素瘤转移。在2例患者中，通过检查和NIR荧光成像确定了多个额外的病变，这些病变在术前常规成像中未被确定。在1例患者中，仅用NIR荧光成像观察到1处计算机断层扫描、磁共振成像、腹腔镜超声检查和检查未识别的额外病变。重要的是，NIR荧光成像在切除这些转移瘤过程中提供了指导。我们描述了成功使用腹腔镜识别和切除葡萄膜黑色素瘤肝转移近红外荧光成像和ICG。这种方法是微创的，应作为补充，以传统的技术检测和切除肝转移。
Uveal melanoma is the most common primary intraocular tumor in adults and up to 50% of patients will develop liver metastases. Complete surgical resection of these metastases can improve 5-year survival, but only a few patients are eligible for radical surgical treatment. The aim of this study was to introduce a near-infrared (NIR) fluorescence laparoscope during minimally-invasive surgery for intraoperative identification of uveal melanoma hepatic metastases and to use it to provide guidance during resection. Three patients diagnosed with one solitary liver metastasis from uveal melanoma are presented. Patients received 10 mg indocyanine green (ICG) intravenously 24 h before surgery. A NIR fluorescence laparoscope was used to detect malignant liver lesions. In all 3 patients, laparoscopic NIR fluorescence imaging using ICG successfully identified uveal melanoma metastases. In 2 patients, multiple additional lesions were identified by inspection and NIR fluorescence imaging, which were not identified by preoperative conventional imaging. In one patient, one additional lesion, not identified by computed tomography, magnetic resonance imaging, laparoscopic ultrasonography and inspection, was observed with NIR fluorescence imaging only.. Importantly, NIR fluorescence imaging provided guidance during resection of these metastases. We describe the successful use of laparoscopic identification and resection of uveal melanoma liver metastases using NIR fluorescence imaging and ICG. This procedure is minimally-invasive, and should be used as complementary to conventional techniques for the detection and resection of liver metastases.
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通讯作者：
Vahrmeijer, Alexander L.
影响因子：
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