Asian Journal of Surgery (Jan 2025)

The application of indocyanine green fluorescence imaging to determine intersegmental plane during thoracoscopic segmentectomy: A meta-analysis and systematic review

  • Dinghang Chen,
  • Ye Lin,
  • Hui Xu,
  • Shuchen Chen,
  • Zhinuan Hong,
  • Mingqiang Kang

Journal volume & issue
Vol. 48, no. 1
pp. 32 – 39

Abstract

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To investigate whether the application of intravenous indocyanine green fluorescence imaging(ICG-FI) had advantage in intersegmental plane visualization and perioperative outcome than using traditional inflation-deflation method(control group) in thoracoscopic segmentectomy. We searched PubMed, Embase, Cochrane Library, EMBASE, Wanfang Database, VIP Database, and CNKI Database to include comparative studies focusing on the comparisons of ICG-FI and control, up to December 2022. We used standard mean differences (SMD, continuous variables) or risk ratios (RR, categorical variables) with their corresponding 95 % confidence interval (CI) were used to assess pooled effects. This analysis was conducted according to the PRISMA guideline. Total, seven published studies with 905 patients (ICG-FI group n = 428, control group n = 477) were included for further analysis. The ICG-FI group was significantly associated with less bleeding during the surgery (SMD = −0.23,95 % CI: −0.08∼-0.38, P < 0.05), shorter surgery time (SMD = −0.87, 95 % CI: −1.75∼-0.17, P < 0.05) and intersegmental boundary line (IBL) presentation time (SMD = −4.50, 95 % CI: −4.97∼-4.07, P < 0.01). The ICG-FI group had shorter postoperative hospitalization time (SMD = −0.18, 95 % CI: −0.34∼-0.03), P < 0.05), and the drainage duration (SMD = −0.18, 95 % CI: −0.34∼-0.03,P < 0.05) than that in the control group. The ICG-FI group also showed the less postoperative complications (RR = 0.75, 95 % CI: 0.64–0.88). There were no significant differences in the number of lymph node resection. No significant publication bias were found in this analysis. Compared with inflation-deflation method, application of ICG-FI in thoracoscopic segmentectomy could reduce operation time, IBL presentation time, length of hospital stay, intraoperative blood loss, and overall complication incidence.

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