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Vol. 100. Issue 9.
Pages 534-554 (September 2022)
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Vol. 100. Issue 9.
Pages 534-554 (September 2022)
Review article
Indocyanine green (ICG) fluorescence guide for the use and indications in general surgery: recommendations based on the descriptive review of the literature and the analysis of experience
Guía de uso e indicaciones de la fluorescencia con verde de indocianina (ICG) en cirugía general: recomendaciones basadas en la revisión descriptiva de la literatura y el análisis de la experiencia
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Salvador Morales-Condea,b, Eugenio Licardieb, Isaias Alarcóna, Andrea Ballaa,c,
Corresponding author
andrea.balla@gmail.com

Corresponding author.
a Unit of Innovation in Minimally Invasive Surgery, Department of General and Digestive Surgery, University Hospital Virgen del Rocio, University of Sevilla, Sevilla, Spain
b Unit of General and Digestive Surgery, Hospital Quironsalud Sagrado Corazón, Sevilla, Spain
c UOC of General and Minimally Invasive Surgery, Hospital “San Paolo”, Civitavecchia, Rome, Italy
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Abstract

Indocyanine Green is a fluorescent substance visible in near-infrared light. It is useful for the identification of anatomical structures (biliary tract, ureters, parathyroid, thoracic duct), the tissues vascularization (anastomosis in colorectal, esophageal, gastric, bariatric surgery, for plasties and flaps in abdominal wall surgery, liver resection, in strangulated hernias and in intestinal ischemia), for tumor identification (liver, pancreas, adrenal glands, implants of peritoneal carcinomatosis, retroperitoneal tumors and lymphomas) and sentinel node identification and lymphatic mapping in malignant tumors (stomach, breast, colon, rectum, esophagus and skin cancer). The evidence is very encouraging, although standardization of its use and randomized studies with higher number of patients are required to obtain definitive conclusions on its use in general surgery.

The aim of this literature review is to provide a guide for the use of ICG fluorescence in general surgery procedures.

Keywords:
Fluorescence
Indocyanine green (ICG)
Minimally invasive surgery
Colorectal surgery
Esophageal surgery
Gastric surgery
Lymph node mapping
Sentinel lymph node
Resumen

El verde de indocianina es una tinción fluorescente visible con luz cercana al infrarrojo. Es útil para la identificación de las estructuras anatómicas (tracto biliar, uréteres, paratiroides, conducto torácico), la vascularización de tejidos (en anastomosis en cirugía colorrectal, esofágica, gástrica, bariátrica, para plastias y colgajos en cirugía de pared abdominal, hepática, en hernias estranguladas en la isquemia intestinal), para la identificación de tumores (hígado, páncreas, suprarrenal, implantes en la carcinomatosis peritoneal, tumores retroperitoneales y linfomas) y para la identificación del ganglio centinela y del mapeo linfático de tumores malignos (cáncer de estómago, mama, colon, recto, esófago y piel). Las evidencias son muy alentadoras, aunque se necesita la estandarización de su uso y más estudios prospectivos y aleatorizados con mayor número de pacientes para obtener conclusiones definitivas sobre su uso.

El objetivo de esta revisión de la literatura es proveer una guía para el uso de la fluorescencia con verde de indocianina en procedimientos de cirugía general.

Palabras clave:
Fluorescencia
Verde de indocianina (ICG)
Cirugía mínimamente invasiva
Cirugía colorrectal
Cirugía esofágica
Cirugía gástrica
Mapeo de ganglios linfáticos
Ganglio linfático centinela

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