scholarly journals Evaluation to Differentiate between Tumor Lesions and the Parenchyma in Partial Nephrectomies for Renal Tumors Based on Quantitative Fluorescence Imaging Using Indocyanine Green Dye

2019 ◽  
Vol 13 (2) ◽  
pp. 74-81
Author(s):  
Norihito Soga ◽  
Akihito Inoko ◽  
Jun Furusawa ◽  
Yuji Ogura
Keyword(s):  
Indocyanine Green ◽  
Success Rate ◽  
Fluorescence Imaging ◽  
Partial Nephrectomy ◽  
Near Infrared ◽  
Clear Cell ◽  
Ex Vivo ◽  
Renal Tumors ◽  
Contrast Imaging ◽  
Malignant Lesions

Introduction: Near-infrared fluorescence imaging with indocyanine green is a useful tool during partial nephrectomy. Because an accurate method for judging hasn't been established yet, the success rate may be slightly different and inconsistent. Materials and Methods: A total of 21 cases with suspected renal cancers who had undergone a partial nephrectomy were enrolled. We examined differences in the success rate between malignant lesions and the parenchyma by quantifying fluorescence in the pre-resection and ex vivo phases. Results: Pre-resection imaging showed a significant degradation of fluorescence in the focused lesion in 76.2% (16/21) of cases. A significant degradation was observed in 73.7% (14/19) of the total malignant lesions, 70.5% (12/17) of cases with a clear cell lesion, 100% (2/2) of cases with non-clear cell lesions, and 100% (2/2) of benign angiomyolipomas. In contrast, imaging of the ex vivo resected specimens showed a significant degradation in fluorescence of the focused lesions in 85.7% (18/21) of cases. A significantly degradation was observed in 84.2% (16/19) of the total malignant lesions, 82.3% (14/17) of cases with a clear cell lesion, 100% (2/2) of cases with non-clear cell lesions, and 100% (2/2) of benign angiomyolipomas. Conclusion: We firstly evaluated the efficacy of quantitative indocyanine green-based fluorescence as an objective method.

scholarly journals Robotic Partial Nephrectomy with Indocyanine Green Fluorescence Navigation

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Lukas Gadus ◽  
Jiri Kocarek ◽  
Frantisek Chmelik ◽  
Marketa Matejkova ◽  
Jiri Heracek
Keyword(s):  
Renal Function ◽  
Indocyanine Green ◽  
Renal Artery ◽  
Fluorescence Imaging ◽  
Partial Nephrectomy ◽  
Fluorescent Imaging ◽  
Renal Tumors ◽  
Robotic Partial Nephrectomy ◽  
Estimated Blood Loss ◽  
The Mean

Partial nephrectomy (PN) is a recommended type of treatment of localised renal tumors. Real-time intraoperative imaging technique, such as fluorescence imaging with indocyanine green (ICG) administration helps to improve intraoperative and postoperative outcomes in patients who underwent PN. Our work presents results of patients who underwent robotic PN with ICG navigation. A total of 37 patients underwent robotic PN with application of ICG between April 2015 and May 2019. A total amount of 5 mg of ICG was applied intravenously, and then robotic PN was performed with fluorescent imaging. ICG was used by the surgeon’s decision according to unfavourable anatomical properties of tumor or to high R.E.N.A.L. nephrometry score. An exact border between perfused and nonperfused tissue was detected, and exact tumor’s branch of the renal artery was clamped. Robotic PN with ICG-fluorescence imaging navigation was performed in 37 cases with a preoperative average diameter of tumor of 31 mm. The mean surgery time was 133 minutes, and the mean estimated blood loss was 190 mL. Arterial clamping was performed in 35 cases. The mean duration of warm ischemia was 14 minutes. Application of ICG enabled specific tumor-supplying vessel clamping in 25 cases. Two complications of grade II according to the Clavien-Dindo classification occurred intraoperatively, and one complication of grade III was observed. Renal function changes showed favourable results for the cases with superselective clamping. Finally, an administration of ICG eases superselective clamping of tumor-specific branch of renal artery and helps to preserve normal renal function with acceptable oncological results.

Sign in / Sign up

Export Citation Format

Share Document