Consensus Conference Statement on the General Use of Near-infrared Fluorescence Imaging and Indocyanine Green Guided Surgery: Results of a Modified Delphi Study.
Consensus Conference Statement on the General Use of Near-infrared Fluorescence Imaging and Indocyanine Green Guided Surgery: Results of a Modified Delphi Study.
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DOI：
10.1097/sla.0000000000004412
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发表时间：
2022-04-01
影响因子：
9
通讯作者：
Rosenthal RJ
中科院分区：
文献类型：
--
作者：
Dip F;Boni L;Bouvet M;Carus T;Diana M;Falco J;Gurtner GC;Ishizawa T;Kokudo N;Lo Menzo E;Low PS;Masia J;Muehrcke D;Papay FA;Pulitano C;Schneider-Koraith S;Sherwinter D;Spinoglio G;Stassen L;Urano Y;Vahrmeijer A;Vibert E;Warram J;Wexner SD;White K;Rosenthal RJ
近几十年来，近红外光和荧光引导在开放式和腹腔镜手术中的使用在各种临床环境中呈指数级增长。然而，在如何执行方面存在巨大的可变性。在首次发表的荧光引导手术国际专家调查中，我们试图确定4个实践领域的共识和非共识领域：基础;患者选择/准备;技术方面;有效性和安全性。对参加2019年9月8日在德国法兰克福举行的为期一天的共识会议的19名荧光引导手术国际专家进行了一项德尔菲调查。使用移动的电话，专家被要求匿名投票超过2轮投票，70%和80%分别被设置为共识和投票鲁棒性的先验阈值。来自五大洲的专家就44项声明中的41项达成了共识，包括近红外荧光引导手术在各种临床环境中既有效又安全的强烈共识，包括血管等关键解剖结构的定位，肿瘤和前哨淋巴结的检测，组织灌注和吻合口漏的评估，分段器官的描绘以及甲状旁腺的定位。尽管ICG的最小和最大安全有效剂量分别为1 - 2 mg和>10 mg，但人们一致认为，确定ICG给药的最佳剂量、浓度、途径和时间应是一个持续的研究重点。 尽管荧光成像在广泛的临床环境中几乎被一致认为是有效和安全的，但仍有必要进行大量的进一步研究以优化其使用。
In recent decades, the use of near-infrared light and fluorescence-guidance during open and laparoscopic surgery has exponentially expanded across various clinical settings. However, tremendous variability exists in how it is performed. In this first published survey of international experts on fluorescence-guided surgery, we sought to identify areas of consensus and nonconsensus across 4 areas of practice: fundamentals; patient selection/preparation; technical aspects; and effectiveness and safety. A Delphi survey was conducted among 19 international experts in fluorescence-guided surgery attending a 1-day consensus meeting in Frankfurt, Germany on September 8th, 2019. Using mobile phones, experts were asked to anonymously vote over 2 rounds of voting, with 70% and 80% set as a priori thresholds for consensus and vote robustness, respectively. Experts from 5 continents reached consensus on 41 of 44 statements, including strong consensus that near-infrared fluorescence-guided surgery is both effective and safe across a broad variety of clinical settings, including the localization of critical anatomical structures like vessels, detection of tumors and sentinel nodes, assessment of tissue perfusion and anastomotic leaks, delineation of segmented organs, and localization of parathyroid glands. Although the minimum and maximum safe effective dose of ICG were felt to be 1 to 2 mg and >10 mg, respectively, there was strong consensus that determining the optimum dose, concentration, route and timing of ICG administration should be an ongoing research focus. Although fluorescence imaging was almost unanimously perceived to be both effective and safe across a broad range of clinical settings, considerable further research remains necessary to optimize its use.
吲哚菁绿辅助黄斑裂孔手术中的内界膜剥离：一项荟萃分析。
影响因子：
3.7
作者：
Wu Y;Zhu W;Xu D;Li YH;Ba J;Zhang XL;Wang F;Yu J
通讯作者：
Yu J