Indocyanine green fluorescence navigation in laparoscopic hepatectomy: a retrospective single-center study of 120 cases

Abstract

Purpose To explore the role of indocyanine green (ICG) fluorescence navigation in laparoscopic hepatectomy and investigate if the timing of its administration influences the intraoperative observation. Methods The subjects of this retrospective study were 120 patients who underwent laparoscopic hepatectomy; divided into an ICG-FN group (n = 57) and a non-ICG-FN group (n = 63). We analyzed the baseline data and operative data. Results There were no remarkable differences in baseline data such as demographic characteristics, lesion-related characteristics, and liver function parameters between the groups. Operative time and intraoperative blood loss were significantly lower in the ICG-FN group. The rate of R0 resection of malignant tumors was comparable in the ICG-FN and non-ICG-FN groups, but the wide surgical margin rate was significantly higher in the ICG-FN group. The administration of ICG 0–3 or 4–7 days preoperatively did not affect the intraoperative fluorescence imaging. Operative time, intraoperative blood loss, and a wide surgical margin correlated with ICG fluorescence navigation. ICG fluorescence navigation helped to minimize intraoperative blood loss and achieve a wide surgical margin. Conclusion ICG fluorescence navigation is safe and efficient in laparoscopic hepatectomy. It helps to achieve a wide surgical margin, which could result in a better prognosis. The administration of ICG 0–3 days preoperatively is acceptable.

Indocyanine green fluorescence-guided laparoscopic hepatectomy versus conventional laparoscopic hepatectomy for hepatocellular carcinoma: A single-center propensity score matching study

“…Other laparoscopic techniques, including appropriate pneumoperitoneum pressure and low central venous pressure, can also reduce intraoperative bleeding (31,32). Previous studies have reported that ICG can reduce intraoperative blood loss (15). Herein, we report a case that supports these results.…”

“…Previous studies have reported that ICG can reduce intraoperative blood loss ( 15 ). Herein, we report a case that supports these results.…”

“…Previous studies have suggested less blood loss, less intraoperative blood transfusion rate, shorter operation time, shorter hospital stay and lower complication rate during surgery with ICG fluorescence navigation ( 5 , 6 , 10 – 14 ). These studies mostly involved only a few cases and lacked propensity score matching (PSM) and prognostic data ( 15 ). Several meta-analyses have been conducted on this topic.…”

Intraoperative fluorescence molecular imaging accelerates the coming of precision surgery in China

“…In this study, Zhang et al also gave the suggestions of administration routes based on their observations. A retrospective analysis conducted by Dai and colleagues demonstrated that FMI-guided resection could achieve a wider negative margin, and therefore lead to a better prognosis compared with the traditional surgery [ 27 ]. With its promising performance, FMI-guided robotic surgery may stand for a future trend of precision treatment.…”

A Pure NanoICG-Based Homogeneous Lipiodol Formulation: Toward Precise Surgical Navigation of Hepatocellular Carcinoma After Long-Term Transcatheter Arterial Embolization

“…In clinical settings, uorescence-guided surgical navigation is promising to achieve speci c operations, realizing an excellent prognosis. Indocyanine green (ICG), the only Food and Drug Administration (FDA) approved near-infrared uorescent agent, has been widely applied in the surgical navigation of solid tumors and metastases, showing low toxicity and prominent optical visualization [9,10]. Despite its advantages, ICG suffers from three critical issues: i) rapid clearance in blood circulation; ii) instability and poor light bleaching resistance; and ) lack of tumor speci city.…”