ABSTRACT
BACKGROUND: Fluorescence-guided surgery (FGS) has emerged as an innovative technique with promising applications in various surgical specialties. However, clinical implementation is hampered by limited availability of evidence-based reference work supporting the translation towards standard-of-care use in surgical practice. Therefore, we developed a consensus statement on current applications of FGS. METHODS: During an international FGS course, participants anonymously voted on 36 statements. Consensus was defined as agreement ≥70% with participation grade of ≥80%. All participants of the questionnaire were stratified for user and handling experience within five domains of applicability (lymphatics & lymph node imaging; tissue perfusion; biliary anatomy and urinary tracts; tumor imaging in colorectal, HPB, and endocrine surgery, and quantification and (tumor-) targeted imaging). Results were pooled to determine consensus for each statement within the respective sections based on the degree of agreement. RESULTS: In total 43/52 (81%) course participants were eligible as voting members for consensus, comprising the expert panel (n = 12) and trained users (n = 31). Consensus was achieved in 17 out of 36 (45%) statements with highest level of agreement for application of FGS in tissue perfusion and biliary/urinary tract visualization (71% and 67%, respectively) and lowest within the tumor imaging section (0%). CONCLUSIONS: FGS is currently established for tissue perfusion and vital structure imaging. Lymphatics & lymph node imaging in breast cancer and melanoma are evolving, and tumor tissue imaging holds promise in early-phase trials. Quantification and (tumor-)targeted imaging are advancing toward clinical validation. Additional research is needed for tumor imaging due to a lack of consensus.
Subject(s)
Breast Neoplasms , Specialties, Surgical , Surgery, Computer-Assisted , Humans , Female , Fluorescence , Surgery, Computer-Assisted/methods , Breast Neoplasms/surgery , Lymph Nodes/pathologySubject(s)
Afterimage/drug effects , Antidepressive Agents, Second-Generation/adverse effects , Depressive Disorder/drug therapy , Triazoles/adverse effects , Antidepressive Agents, Second-Generation/administration & dosage , Chronic Disease , Depressive Disorder/psychology , Humans , Male , Middle Aged , Piperazines , Triazoles/administration & dosageSubject(s)
Alzheimer Disease/drug therapy , Cholinergic Antagonists/therapeutic use , Cholinesterase Inhibitors/adverse effects , Gastrointestinal Diseases/chemically induced , Gastrointestinal Diseases/prevention & control , Propantheline/therapeutic use , Tacrine/adverse effects , Aged , Cholinergic Antagonists/administration & dosage , Cholinesterase Inhibitors/administration & dosage , Cholinesterase Inhibitors/therapeutic use , Drug Administration Schedule , Drug Therapy, Combination , Humans , Male , Middle Aged , Propantheline/administration & dosage , Tacrine/administration & dosage , Tacrine/therapeutic useABSTRACT
Twenty-nine patients given unilateral ECT were tested for memory with each treatment. Forgetting of nonverbal material correlated positively with seizure duration and with anesthetic dose. Seizure duration did not correlate with forgetting of verbal material or with changes in Hamilton depression ratings. Seizure duration was inversely related to succinylcholine and methohexital doses. These findings suggest that muscle relaxant and anesthetic doses can be adjusted to lessen the amnestic effects of ECT. There are, however, insufficient data on the relationship between seizure length and ECT efficacy to specify a minimum duration for seizures, individually or cumulatively.