Indocyanine Green to Assess Vascularity of Ileal Conduit Anastomosis During Pelvic Exenteration for Recurrent/Persistent Gynecological Cancer: A Pilot Study

IntroductionPelvic exenteration performed for recurrent/persistent gynecological malignancies has been associated with urological short- and long-term morbidity due to altered vascularization of tissues for previous radiotherapy. The aims of the present study were to describe the use of intravenous indocyanine green (ICG) to assess vascularity of urinary diversion (UD) after pelvic exenteration for gynecologic cancers, to evaluate the feasibility and safety of this technique, and to assess the postoperative complications.MethodsProspective, observational, single-center, pilot study including consecutive patients undergoing anterior or total pelvic exenteration due to persistent/recurrent gynecologic cancers between August 2020 and March 2021 at Fondazione Policlinico Gemelli IRCCS, Rome, Italy. All patients underwent intravenous injection of 3–6 ml of ICG (1.25 mg/ml) once the UD was completed. A near-infrared camera was used to evaluate ICG perfusion of anastomoses (ileum–ileum, right and left ureter with small bowel, and colostomy or colorectal sides of anastomosis) a few seconds after ICG injection.ResultsFifteen patients were included in the study. No patient reported adverse reactions to ICG injection. Only 3/15 patients (20.0%) had an optimal ICG perfusion in all anastomoses. The remaining 12 (80.0%) patients had at least one ICG deficit; the most common ICG deficit was on the left ureter: 3 (20.0%) vs. 1 (6.7%) patient had no ICG perfusion on the left vs. right ureter, respectively (p = 0.598). 8/15 (53.3%) and 6/15 (40.0%) patients experienced grade ≥3 30-day early and late postoperative complications, respectively. Of these, two patients had early and one had late postoperative complications directly related to poor perfusion of anastomosis (UD leak, ileum–ileum leak, and benign ureteric stricture); all these cases had a suboptimal intraoperative ICG perfusion.ConclusionThe use of ICG to intraoperatively assess the anastomosis perfusion at time of pelvic exenteration for gynecologic malignancy is a feasible and safe technique. The different vascularization of anastomotic stumps may be related to anatomical sites and to previous radiation treatment. This approach could be in support of selecting patients at higher risk of complications who may need personalized follow-up.

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Noninvasive Measurement of Cerebral Blood Flow in Adults Using Near-Infrared Spectroscopy and Indocyanine Green: A Pilot Study

Journal of Neurosurgical Anesthesiology ◽

10.1097/00008506-200207000-00008 ◽

2002 ◽

Vol 14 (3) ◽

pp. 218-222 ◽

Cited By ~ 52

Author(s):

Felix Gora ◽

Samantha Shinde ◽

Clare E. Elwell ◽

John C. Goldstone ◽

Mark Cope ◽

...

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Infrared Spectroscopy ◽

Pilot Study ◽

Indocyanine Green ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Noninvasive Measurement

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Use of near-infrared imaging using indocyanine green associates with the lower incidence of postoperative complications for intestinal and mesenteric injury

Scientific Reports ◽

10.1038/s41598-021-03361-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Keishi Yamaguchi ◽

Takeru Abe ◽

Kento Nakajima ◽

Chikara Watanabe ◽

Yusuke Kawamura ◽

...

Keyword(s):

Postoperative Complications ◽

Indocyanine Green ◽

Anastomotic Leakage ◽

Lower Incidence ◽

Lower Risk ◽

Near Infrared ◽

Infrared Imaging ◽

Intestinal Resection ◽

Near Infrared Imaging ◽

Vascular Perfusion

AbstractAnastomotic leakage after intestinal resection is one of the most serious complications of surgical intervention for hollow viscus injury. Adequate vascular perfusion of the anastomotic site is essential to prevent anastomotic leakage. Near-infrared imaging using indocyanine green (NIR-ICG) is useful for the objective assessment of vascular perfusion. The aim of this study was to evaluate the association of NIR-ICG with intestinal and mesenteric injuries. This was a retrospective, single-center study of patients undergoing surgery for intestinal and mesenteric injuries. NIR-ICG was used to evaluate vascular perfusion. Postoperative complications were assessed between NIR-ICG and non-NIR-ICG groups.The use of NIR-ICG was associated with a lower incidence of Clavien-Dindo grade ≥ III complications with a statistical tendency (p = 0.076). When limited to patients that underwent intestinal resection, the use of NIR-ICG was significantly associated with a lower risk of perioperative complications (p = 0.009). The use of NIR-ICG tended to associate with the lower incidence of postoperative complications after intestinal and mesenteric trauma surgery. NIR-ICG was associated with a significantly lower risk of complications in patients undergoing intestinal resection. The NIR-ICG procedure is simple and quick and is expected to be useful for intestinal and mesenteric trauma.

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Use of Near-Infrared Imaging using Indocyanine Green Associates with the Lower Incidence of Postoperative Complications After Surgery for Intestinal and Mesenteric Injury

10.21203/rs.3.rs-829393/v1 ◽

2021 ◽

Author(s):

Keishi Yamaguchi ◽

Takeru Abe ◽

Kento Nakajima ◽

Chikara Watanabe ◽

Yusuke Kawamura ◽

...

Keyword(s):

Postoperative Complications ◽

Indocyanine Green ◽

Anastomotic Leakage ◽

Lower Incidence ◽

Lower Risk ◽

Near Infrared ◽

Infrared Imaging ◽

Intestinal Resection ◽

Near Infrared Imaging ◽

Vascular Perfusion

Abstract BackgroundAnastomotic leakage after intestinal resection is one of the most serious complications of surgical intervention for hollow viscus injury. Adequate vascular perfusion of the anastomotic site is essential to prevent anastomotic leakage. Near-infrared imaging using indocyanine green (NIR-ICG) is useful for the objective assessment of vascular perfusion. The aim of this study was to evaluate the association of NIR-ICG with intestinal and mesenteric injuries.MethodsThis was a retrospective, single-center study of patients undergoing surgery for intestinal and mesenteric injuries due to abdominal trauma from December 2006 to March 2021. NIR-ICG was used to evaluate vascular perfusion. Postoperative complications were assessed between NIR-ICG and non-NIR-ICG groups. ResultsThe use of NIR-ICG was associated with a lower incidence of Clavien-Dindo grade ≥ III complications with a statistical tendency (p = 0.076). No Clavien-Dindo grade ≥ II intestinal complications were observed in the NIR-ICG group. When limited to patients that underwent intestinal resection, the use of NIR-ICG was significantly associated with a lower risk of perioperative complications (p = 0.009).ConclusionsThe use of NIR-ICG tended to associate with the lower incidence of postoperative complications after intestinal and mesenteric trauma surgery. NIR-ICG was associated with a significantly lower risk of complications in patients undergoing intestinal resection. The NIR-ICG procedure is simple and quick and is expected to be useful for intestinal and mesenteric trauma.

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A Pilot Study on the Use of Indocyanine Green Near-Infrared Technique for Sentinel Lymph Node Biopsy in Early Endometrial Cancers in Singapore

Journal of Gynecologic Surgery ◽

10.1089/gyn.2019.0070 ◽

2020 ◽

Vol 36 (6) ◽

pp. 319-324

Author(s):

Yong Kuei Lim ◽

Weng Yan Ho ◽

Wai Loong Wong ◽

Ieera Aggarwal ◽

Kwai Lam Yam

Keyword(s):

Lymph Node ◽

Pilot Study ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Indocyanine Green ◽

Near Infrared ◽

Lymph Node Biopsy ◽

Node Biopsy ◽

Endometrial Cancers

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332 Indocyanine green to assess vascularity of ileal conduit anastomosis during pelvic exenteration for recurrent/persistent gynecological cancer

10.1136/ijgc-2021-esgo.24 ◽

2021 ◽

Author(s):

N Bizzarri ◽

N Foschi ◽

M Loverro ◽

L Tortorella ◽

F Santullo ◽

...

Keyword(s):

Indocyanine Green ◽

Pelvic Exenteration ◽

Ileal Conduit ◽

Gynecological Cancer

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A Pilot Study of Pulmonary Segmentectomy With Indocyanine Green Near-Infrared Angiography

Surgical Innovation ◽

10.1177/1553350618824914 ◽

2019 ◽

Vol 26 (3) ◽

pp. 337-343 ◽

Cited By ~ 2

Author(s):

Ruiji Chen ◽

Yongfu Ma ◽

Chengrun Li ◽

Yunjing Li ◽

Bo Yang ◽

...

Keyword(s):

Pilot Study ◽

Indocyanine Green ◽

Chest Tube ◽

Near Infrared ◽

Thoracoscopic Surgery ◽

Operation Time ◽

Ground Glass Opacity ◽

Perioperative Period ◽

Intersegmental Plane ◽

The Mean

Objectives. Video-assisted thoracoscopic surgery (VATS) pulmonary segmentectomy is commonly used in treating small ground-glass opacity (GGO) nodules in lung. The identification of the intersegmental plane is one of the challenges. In this pilot study, we aimed to evaluate the feasibility of indocyanine green (ICG) angiography in VATS segmentectomy. Methods. Nineteen GGO patients were enrolled, and VATS segmentectomy with ICG near-infrared angiography were performed between July 2017 and December 2017. Conventional 3-port VATS was used. ICG was injected intravenously after dominant arties were ligated. Intersegmental plane was identified and divided by stapler and electrocautery. Results. All patients had perfect intersegmental plane visualization. The mean operation time was 140.8 minutes, and the mean blood loss was 23.7 mL. No complications due to ICG occurred. The mean chest tube duration was 4.6 days. No severe complications occurred in the perioperative period. The mean chest tube drainage duration was 4.6 days. Prolonged postoperative air leak (>5 days), which required no surgical intervention, occurred in 2 cases. There were no severe complications or in-hospital deaths. Conclusions. VATS segmentectomy with ICG near-infrared angiography is a reasonable treatment option to treat small GGO in lung, especially due to its good surgical view maintenance.

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Near-Infrared Imaging Using Intravenous Indocyanine Green at a Conventional Dose to Locate Pulmonary Metastases: A Pilot Study

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0038-1675346 ◽

2018 ◽

Vol 67 (08) ◽

pp. 688-691 ◽

Cited By ~ 1

Author(s):

Masatsugu Hamaji ◽

Toyofumi Fengshi Chen-Yoshikawa ◽

Manabu Minami ◽

Hiroshi Date

Keyword(s):

Computed Tomography ◽

Pilot Study ◽

Indocyanine Green ◽

Near Infrared ◽

Infrared Imaging ◽

Pulmonary Metastases ◽

Pulmonary Metastasectomy ◽

Maximum Diameter ◽

Conventional Dose ◽

Metastatic Lesions

AbstractIntravenous indocyanine green (ICG) has been reported to localize intra-abdominal metastatic lesions in several clinical trials. Our pilot study aimed to investigate the feasibility and safety of ICG fluorescence localization in pulmonary metastasectomy using a near-infrared fluorescence thoracoscope. Each patient received intravenous 0.25 or 0.5 mg/kg of ICG. The maximum diameter of the tumor on computed tomography ranged from 0.5 to 3.5 (median: 1.15) cm. Intravenous ICG injection localized pulmonary metastases in a portion (3 patients) of the enrolled patients. Our preliminary results provided us with important information to modify the study protocol.

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