Use of fluorescence imaging during lymphatic surgery: A Delphi survey of experts worldwide
Por:
Dip F., Alexandru N., Amore M., Becker C., Belgrado J.-P., Bourgeois P., Chang E.I.-F., Koshima I., Liberale G., Masia J., Mortimer P., Neligan P., Batista B.N., Olszewski W., Salvia S.A., Suami H., Vankerckhove S., Yamamoto T., Lo Menzo E., White K.P., Rosenthal R.J.
Publicada:
1 ene 2022
Resumen:
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. © 2022
Filiaciones:
Dip F.:
Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
Alexandru N.:
Universitatea de Medicina si Farmacie Victor Babes, Timisoara, Romania
Amore M.:
Central Military Hospital, Buenos Aires, Argentina
Becker C.:
AP-HP Hôpital Européen Georges Pompidou, Paris, France
Belgrado J.-P.:
University of Brussels, Brussels, Belgium
Bourgeois P.:
University of Brussels, Brussels, Belgium
Chang E.I.-F.:
MD Anderson Cancer Center, Houston, TX
Koshima I.:
Tottori University, Tottori, Japan
Liberale G.:
University of Brussels, Brussels, Belgium
Masia J.:
Department Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Spain
Mortimer P.:
St. Georges University Hospital, London, United Kingdom
Neligan P.:
University of Washington, Seattle, WA, United States
Batista B.N.:
AC Camargo Cancer Center, São Paulo, Brazil
Olszewski W.:
Polish Academy of Sciences, Warsaw, Poland (Deceased)
Salvia S.A.:
Central Military Hospital, Buenos Aires, Argentina
Suami H.:
Australian Lymphedema Education, Research and Treatment (ALERT), Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
Vankerckhove S.:
University of Brussels, Brussels, Belgium
Yamamoto T.:
National Center for Global Health and Medicine, Tokyo, Japan
Lo Menzo E.:
Cleveland Clinic Florida, Weston, FL
White K.P.:
ScienceRight Research Consulting Services, London, ON, Canada
Rosenthal R.J.:
Cleveland Clinic Florida, Weston, FL
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