Use of fluorescence imaging during lymphatic surgery : A Delphi survey of experts worldwide
Dip, Fernando (Hospital de Clínicas José de San Martín)
Alexandru, Nistor (Universitatea de Medicina si Farmacie Victor Babes)
Amore, Miguel (Central Military Hospital)
Becker, Corinne (Hôpital Européen Georges Pompidou (París, França))
Belgrado, Jean-Paul (University of Brussels)
Bourgeois, Pierre (University of Brussels)
Chang, Edward I-Fei (MD Anderson Cancer Center)
Koshima, Isao (Tottori University)
Liberale, Gabriel (University of Brussels)
Masià, Jaume (Institut d'Investigació Biomèdica Sant Pau)
Mortimer, Peter (St. Georges University Hospital)
Neligan, Peter (University of Washington)
Batista, Bernardo Noriega (A.C.Camargo Cancer Center (Brasil))
Olszewski, Waldemar (Polish Academy of Sciences)
Salvia, Sophia Alexia (Central Military Hospital)
Suami, Hiroo (Australian Lymphedema Education. Research and Treatment (ALERT). Faculty of Medicine. Health and Human Sciences. Macquarie University)
Vankerckhove, Sophie (University of Brussels)
Yamamoto, Takumi (National Center for Global Health and Medicine)
Lo Menzo, Emanuele (Cleveland Clinic Florida)
White, Kevin P. (ScienceRight Research Consulting Services)
Rosenthal, Raul J. (Cleveland Clinic Florida)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Background: Fluorescence imaging with indocyanine green is increasingly used during lymphedema patient management. However, to date, no guidelines exist on when it should and should not be used or how it should be performed. Our objective was to have an international panel of experts identify areas of consensus and nonconsensus in current attitudes and practices in fluorescence imaging with indocyanine green use during lymphedema surgery patient management. Methods: A 2-round Delphi study was conducted involving 18 experts in the use of fluorescence imaging during lymphatic surgery, all asked to vote on 49 statements on patient preparation and contraindications (n = 7 statements), indocyanine green dosing and administration (n = 10), fluorescence imaging uses and potential advantages (n = 16), and potential disadvantages and training needs (n = 16). Results: Consensus ultimately was reached on 40/49 statements, including consistent consensus regarding the value of fluorescence imaging with indocyanine green in almost all facets of lymphedema patient management, including early detection, assessing disease extent, preoperative work-up, surgical planning, intraoperative guidance, monitoring short- and longer-term outcomes, quality control, and resident training. All experts felt it was very safe, while 94% felt it should be part of routine care and that indocyanine green was superior to colored dyes and ultrasound. Nonetheless, there also was consensus that limited high-quality evidence remains a barrier to its widespread use and that patients should still be provided with specific information and asked to sign specific consent for both fluorescence imaging and indocyanine green. Conclusion: Fluorescence imaging with or without indocyanine green appears to have several roles in lymphedema prevention, diagnosis, assessment, and treatment.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Coloring Agents ; Humans ; Indocyanine Green ; Lymphatic Vessels ; Lymphedema ; Optical Imaging
Publicat a:	Surgery (United States), Vol. 172 Núm. 6 (december 2022) , p. S14-S20, ISSN 1532-7361

DOI: 10.1016/j.surg.2022.08.026
PMID: 36427924

7 p, 321.7 KB

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