Tricks and traps of ICG endoscopy for effectively applying endoscopic transsphenoidal surgery to pituitary adenoma.
Endoscopic endonasal transsphenoidal surgery
Indocyanine green fluorescence
Pituitary
Journal
Neurosurgical review
ISSN: 1437-2320
Titre abrégé: Neurosurg Rev
Pays: Germany
ID NLM: 7908181
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
11
05
2020
accepted:
01
09
2020
revised:
02
08
2020
pubmed:
6
9
2020
medline:
2
10
2021
entrez:
5
9
2020
Statut:
ppublish
Résumé
Differentiating tumor from normal pituitary gland is very important for achieving complete resection without complications in endoscopic endonasal transsphenoidal surgery (ETSS) for pituitary adenoma. To facilitate such surgery, we investigated the utility of indocyanine green (ICG) fluorescence endoscopy as a tool in ETSS. Twenty-four patients with pituitary adenoma were enrolled in the study and underwent ETSS using ICG endoscopy. After administering 12.5 mg of ICG twice an operation with an interval > 30 min, times from ICG administration to appearance of fluorescence on vital structures besides the tumor were measured. ICG endoscopy identified vital structures by the phasic appearance of fluorescent signals emitted at specific consecutive elapsed times. Elapsed times for internal carotid arteries did not differ according to tumor size. Conversely, as tumor size increased, elapsed times for normal pituitary gland were prolonged but those for the tumor were reduced. ICG endoscopy revealed a clear boundary between tumors and normal pituitary gland and enabled confirmation of no more tumor. ICG endoscopy could provide a useful tool for differentiating tumor from normal pituitary gland by evaluating elapsed times to fluorescence in each structure. This method enabled identification of the boundary between tumor and normal pituitary gland under conditions of a low-fluorescence background, resulting in complete tumor resection with ETSS. ICG endoscopy will contribute to improve the resection rate while preserving endocrinological functions in ETSS for pituitary adenoma.
Identifiants
pubmed: 32889658
doi: 10.1007/s10143-020-01382-4
pii: 10.1007/s10143-020-01382-4
doi:
Substances chimiques
Indocyanine Green
IX6J1063HV
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2133-2143Informations de copyright
© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.
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