Role of fluorescence imaging for intraoperative intestinal assessment in gynecological surgery: a systematic review.
Minim Invasive Ther Allied Technol
; 31(7): 992-999, 2022 Oct.
Article
en En
| MEDLINE
| ID: mdl-35442833
ABSTRACT
BACKGROUND:
Our aim was to review the current knowledge of the role of fluorescence imaging for intraoperative intestinal assessment in gynecological surgery. MATERIAL ANDMETHODS:
A computer-based systematic review was performed from 2000 to 2020. All articles describing the use of indocyanine green (ICG) applied to bowel assessments in gynecology or endometriosis surgery were considered for review.RESULTS:
ICG is an effective tool for assessing bowel vascularization, potentially preventing anastomotic leakage and recto-vaginal fistula and can therefore be useful for endometriosis surgery or bowel assessment in gynecological oncology procedures. Real-time characterization of the hypovascular pattern of endometriotic nodules has been associated with a larger nodule size and lower microvessel density, helping surgeons choose the best transecting line and the most appropriate technique. ICG angiography allows for a laparoscopic and intrarectal bowel assessment, which can act as a double check of bowel perfusion, enabling the assessment of mucosa vascularization. ICG fluorescence can guide intraoperative decision-making after intestinal anastomosis, discoid resection, and rectal shaving, preventing anastomotic leakage and postoperative recto-vaginal fistula in low anterior resections.CONCLUSIONS:
ICG angiography provides a better intestinal assessment. Larger, prospective, randomized controlled studies are needed to validate the technique and confirm these encouraging results.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_doencas_nao_transmissiveis
Asunto principal:
Fístula Vaginal
/
Laparoscopía
/
Endometriosis
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Systematic_reviews
Límite:
Female
/
Humans
Idioma:
En
Revista:
Minim Invasive Ther Allied Technol
Asunto de la revista:
TERAPEUTICA
Año:
2022
Tipo del documento:
Article
País de afiliación:
España