A Novel Indocyanine Green Fluorescence-Guided Video-Assisted Technique for Sentinel Node Biopsy in Breast Cancer

被引:30
|
作者
Sorrentino, Luca [1 ]
Sartani, Alessandra [1 ]
Pietropaolo, Gaia [1 ]
Bossi, Daniela [2 ]
Mazzucchelli, Serena [3 ]
Truffi, Marta [3 ]
Foschi, Diego [1 ,3 ]
Corsi, Fabio [2 ,3 ]
机构
[1] Luigi Sacco Univ Hosp, Surg Div, ASST Fatebenefratelli Sacco, Via GB Grassi 74, I-20157 Milan, Italy
[2] ICS Maugeri SpA SB, Surg Dept, Breast Unit, Via Maugeri 10, I-27100 Pavia, Italy
[3] Univ Milan, Dept Biomed & Clin Sci Luigi Sacco, Via GB Grassi 74, I-20157 Milan, Italy
关键词
LYMPH-NODES; BLUE-DYE; RADIOISOTOPE METHOD; METAANALYSIS; TRIAL; IDENTIFICATION; MELANOMA; SURGERY; TRACER;
D O I
10.1007/s00268-018-4534-9
中图分类号
R61 [外科手术学];
学科分类号
摘要
The equipment to detect indocyanine green (ICG) fluorescence for sentinel lymph node (SLN) biopsy in breast cancer is not widely accessible nor optimal. The fluorescence appears as a poorly defined white shine on a black background, and dimmed lighting is required. The aim of this study was to assess the feasibility, accuracy and healthcare costs of a novel approach for SLN biopsy by a video-assisted ICG-guided technique. The technique for detecting SLN was radioisotope (RI) in 194 cases, video-assisted ICG-guided in 70 cases and a combined method in 71 cases. In the video-assisted ICG group, a full HD laparoscopic system equipped with xenon lamps was used for a laser-free detection of ICG within a colored and magnified high-resolution image. Detection of ICG fluorescence using a laparoscope with a near-infrared filter provided a highly defined and colored image during SLN biopsy. SLN was identified in 100% of patients in all groups. Multiple SLNs were identified in 0.5% of RI patients, in 12.9% of ICG patients and in 14.1% of ICG + RI patients (p < 0.0001). In ICG + RI group, 95.1% of lymph nodes were radioactive and 92.7% were fluorescent. Operative times and healthcare costs were equivalent between groups. Video-assisted ICG-guided technique is a feasible and surgeon-friendly method for SLN biopsy, with equivalent efficacy compared to RI, providing an accurate staging of the axilla.
引用
收藏
页码:2815 / 2824
页数:10
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