Subcutaneous Vulvar Flap Viability Evaluation With Near-Infrared Probe and Indocyanine Green for Vulvar Cancer Reconstructive Surgery: A Feasible Technique.
Subcutaneous Vulvar Flap Viability Evaluation With Near-Infrared Probe and Indocyanine Green for Vulvar Cancer Reconstructive Surgery: A Feasible Technique.
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DOI：
10.3389/fsurg.2021.721770
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发表时间：
2021
影响因子：
1.8
通讯作者：
Berretta R
中科院分区：
文献类型：
--
作者：
Capozzi VA;Monfardini L;Sozzi G;Armano G;Rosati A;Gueli Alletti S;Cosentino F;Ercoli A;Cianci S;Berretta R
外阴癌是一种影响老年妇女的罕见疾病，占所有妇科癌症的3-5%。初次手术治疗涉及切除大量组织，通常需要进行重建手术，术后并发症发生率高。尽管已经提出了几种用于评估外阴皮瓣活力的技术，但许多方法不能在手术期间进行，并且需要昂贵的设备，这些设备在妇科诊所中经常缺失。本研究旨在通过近红外内窥镜探头和吲哚菁绿色（ICG）示踪剂在一小群患者中验证外阴皮瓣活力评估的可行性和安全性，并评估外阴皮瓣的长期结局。研究方法：本研究前瞻性纳入了需要手术治疗和后续外阴皮瓣重建手术的原发性外阴癌患者。在闭合皮瓣的皮肤边缘之前，静脉输注稀释于20 ml盐水溶液中的25 mg ICG小瓶。所有患者均静脉给予0.2 mg/kg体重的ICG。10-15 min后，使用近红外内窥镜探头评估外阴皮瓣的存活率。结果：在研究期间接受外阴癌根治性切除术的18例患者中，15例纳入分析。所有包装的手术皮瓣均显示手术边缘有示踪剂摄取。没有记录到手术相关或染料输注相关的术中并发症。未记录手术感染、裂开或坏死。结论：吲哚菁绿色和腹腔镜红外探头联合应用评价外阴皮瓣成活率是一种可行的方法。分析中的所有病例均显示皮瓣手术边缘有染料吸收。此外，还需要前瞻性研究来证实该方法在临床实践中的作用，并评价其优于简单的主观临床评价。
Introduction: Vulvar cancer is a rare condition affecting older women and accounts for 3–5% of all gynecological cancers. Primary surgical treatment involves the removal of a large amount of tissue for which reconstructive surgery is often necessary with a high rate of postoperative complications. Despite several techniques for the evaluation of vulvar flap viability have been proposed, many methods cannot be performed during surgery and require expensive devices often missing in a gynecological clinic. This study aims to verify the feasibility and the safety of the vulvar flap viability evaluation through a near-infrared endoscopic probe and Indocyanine green (ICG) tracer in a small group of patients and to evaluate long-term vulvar flap outcomes. Methods: Patients with primary vulvar cancer who required surgical treatment and subsequent vulvar flap reconstructive surgery were prospectively included in the study. A 25 mg ICG vial diluted in 20 ml of saline solution was intravenously infused before closing the skin edges of the flaps. All patients were given 0.2 mg/kg body weight of intravenous ICG. After 10–15 min, a near-infrared endoscopic probe was used to evaluate the vulvar flap viability. Results: Of the 18 patients who underwent radical vulvectomy for vulvar cancer during the study period, 15 were included in the analysis. All packaged surgical flaps showed tracer uptake on the surgical margin. No intro-operative complications were recorded neither surgery-related nor to dye infusion. No surgical infection, dehiscence, or necrosis was recorded. Conclusions: Vulvar flap viability assessment using Indocyanine green and a laparoscopic infrared probe is a feasible method. All cases included in the analysis showed a dye uptake on the surgical edge of the flap. Further, prospective studies are needed to confirm the method in clinical practice and to evaluate its superiority over simple subjective clinical evaluation.
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DOI：
10.1054/bjps.2002.3969
发表时间：
2002-12-01
期刊：
BRITISH JOURNAL OF PLASTIC SURGERY
影响因子：
--
作者：
Holm, C;Mayr, M;Mühlbauer, W
通讯作者：
Mühlbauer, W
影响因子：
1.3
作者：
Cianci, S.;Alletti, S. Gueli;Uccella, S.
通讯作者：
Uccella, S.
影响因子：
3.8
作者：
Rogers, Linda J.;Cuello, Mauricio A.
通讯作者：
Cuello, Mauricio A.
DOI：
10.1016/j.ejogrb.2019.01.024
发表时间：
2019-03-01
影响因子：
2.6
作者：
Alletti, S. Gueli;Cianci, S.;Rossitto, C.
通讯作者：
Rossitto, C.
DOI：
10.1016/j.ejogrb.2019.12.020
发表时间：
2020-02-01
影响因子：
2.6
作者：
Alletti, Salvatore Gueli;Perrone, Emanuele;Rossitto, Cristiano
通讯作者：
Rossitto, Cristiano