Real-Time Fluorescence Imaging for Thoracic Duct Identification during Oesophagectomy: A Systematic Review of the Literature
Postoperative chylothorax is a serious complication after oesophagectomy. Real-time identification of the thoracic duct (TD) could prevent injury or facilitate prompt management when it occurs. Intraoperative TD lymphography with indocyanine green (ICG) is a novel technique that may help prevent...
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| Format: | Article |
| Language: | English |
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Korean Society for Thoracic & Cardiovascular Surgery
2025-01-01
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| Series: | Journal of Chest Surgery |
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| _version_ | 1841560990168121344 |
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| author | Dimitra V. Peristeri Minas Baltatzis |
| author_facet | Dimitra V. Peristeri Minas Baltatzis |
| author_sort | Dimitra V. Peristeri |
| collection | DOAJ |
| description | Postoperative chylothorax is a serious complication after oesophagectomy. Real-time
identification of the thoracic duct (TD) could prevent injury or facilitate prompt management
when it occurs. Intraoperative TD lymphography with indocyanine green (ICG) is a
novel technique that may help prevent chyle leaks following thoracic surgery. A systematic
search of PubMed, Embase, MEDLINE, Scopus, and the Cochrane Library for studies published
until July 2024 evaluating ICG for TD identification during oesophagectomy was
performed. Studies were included in the review if they assessed intraoperative TD identification
with ICG to prevent chyle leakage in patients undergoing oesophagectomy. Nine
of 265 screened papers were included in the present review, with 3 reporting comparative
techniques of TD identification between patients. Only 1 study had a control group without
ICG administration. TD was identified in 281 of the 303 patients who received ICG.
Chyle leak incidence was 0.66% in the ICG group. The mean observation time of TD after
ICG administration was 162 minutes. Most of the included patients received neoadjuvant
treatment before surgery. Different application routes of ICG have been reported, with the
most prominent one being through the inguinal region under ultrasound guidance. Real-
time TD identification with ICG might be a valuable tool for avoiding injury or managing
it intraoperatively. To our knowledge, this is the first systematic review on this complex topic.
However, as no randomized controlled trials have been published, sufficient evidence
is needed to determine whether the aforementioned method can sufficiently reduce the
chyle leak rate. |
| format | Article |
| id | doaj-art-bceb67a84cbd4597b72984ae1f892aef |
| institution | Kabale University |
| issn | 2765-1606 2765-1614 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Korean Society for Thoracic & Cardiovascular Surgery |
| record_format | Article |
| series | Journal of Chest Surgery |
| spelling | doaj-art-bceb67a84cbd4597b72984ae1f892aef2025-01-03T07:07:48ZengKorean Society for Thoracic & Cardiovascular SurgeryJournal of Chest Surgery2765-16062765-16142025-01-0158151410.5090/jcs.24.091Real-Time Fluorescence Imaging for Thoracic Duct Identification during Oesophagectomy: A Systematic Review of the LiteratureDimitra V. Peristeri0https://orcid.org/0000-0003-3806-028XMinas Baltatzis1https://orcid.org/0000-0001-6476-5537Department of Upper GI Surgery, Salford Royal Foundation Trust, Northern Care Alliance, Salford, UKDepartment of Upper GI Surgery, Salford Royal Foundation Trust, Northern Care Alliance, Salford, UKPostoperative chylothorax is a serious complication after oesophagectomy. Real-time identification of the thoracic duct (TD) could prevent injury or facilitate prompt management when it occurs. Intraoperative TD lymphography with indocyanine green (ICG) is a novel technique that may help prevent chyle leaks following thoracic surgery. A systematic search of PubMed, Embase, MEDLINE, Scopus, and the Cochrane Library for studies published until July 2024 evaluating ICG for TD identification during oesophagectomy was performed. Studies were included in the review if they assessed intraoperative TD identification with ICG to prevent chyle leakage in patients undergoing oesophagectomy. Nine of 265 screened papers were included in the present review, with 3 reporting comparative techniques of TD identification between patients. Only 1 study had a control group without ICG administration. TD was identified in 281 of the 303 patients who received ICG. Chyle leak incidence was 0.66% in the ICG group. The mean observation time of TD after ICG administration was 162 minutes. Most of the included patients received neoadjuvant treatment before surgery. Different application routes of ICG have been reported, with the most prominent one being through the inguinal region under ultrasound guidance. Real- time TD identification with ICG might be a valuable tool for avoiding injury or managing it intraoperatively. To our knowledge, this is the first systematic review on this complex topic. However, as no randomized controlled trials have been published, sufficient evidence is needed to determine whether the aforementioned method can sufficiently reduce the chyle leak rate.fluorescenceesophagectomyminimally invasive surgerythoracic duct identificationindocyanine green |
| spellingShingle | Dimitra V. Peristeri Minas Baltatzis Real-Time Fluorescence Imaging for Thoracic Duct Identification during Oesophagectomy: A Systematic Review of the Literature Journal of Chest Surgery fluorescence esophagectomy minimally invasive surgery thoracic duct identification indocyanine green |
| title | Real-Time Fluorescence Imaging for Thoracic Duct Identification during Oesophagectomy: A Systematic Review of the Literature |
| title_full | Real-Time Fluorescence Imaging for Thoracic Duct Identification during Oesophagectomy: A Systematic Review of the Literature |
| title_fullStr | Real-Time Fluorescence Imaging for Thoracic Duct Identification during Oesophagectomy: A Systematic Review of the Literature |
| title_full_unstemmed | Real-Time Fluorescence Imaging for Thoracic Duct Identification during Oesophagectomy: A Systematic Review of the Literature |
| title_short | Real-Time Fluorescence Imaging for Thoracic Duct Identification during Oesophagectomy: A Systematic Review of the Literature |
| title_sort | real time fluorescence imaging for thoracic duct identification during oesophagectomy a systematic review of the literature |
| topic | fluorescence esophagectomy minimally invasive surgery thoracic duct identification indocyanine green |
| work_keys_str_mv | AT dimitravperisteri realtimefluorescenceimagingforthoracicductidentificationduringoesophagectomyasystematicreviewoftheliterature AT minasbaltatzis realtimefluorescenceimagingforthoracicductidentificationduringoesophagectomyasystematicreviewoftheliterature |