Tricks and traps of ICG endoscopy for effectively applying endoscopic transsphenoidal surgery to pituitary adenoma View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-09-05

AUTHORS

Akihiro Inoue, Shohei Kohno, Takanori Ohnishi, Naoya Nishida, Satoshi Suehiro, Yawara Nakamura, Shirabe Matsumoto, Masahiro Nishikawa, Saya Ozaki, Seiji Shigekawa, Hideaki Watanabe, Hidenori Senba, Hironobu Nakaguchi, Mashio Taniwaki, Bunzo Matsuura, Riko Kitazawa, Takeharu Kunieda

ABSTRACT

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. More... »

PAGES

2133-2143

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10143-020-01382-4

DOI

http://dx.doi.org/10.1007/s10143-020-01382-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1130621203

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32889658


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18 schema:description 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.
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25 ICG administration
26 Indocyanine Green Fluorescence Endoscopy
27 adenomas
28 administration
29 appearance
30 appearance of fluorescence
31 artery
32 background
33 boundaries
34 carotid artery
35 clear boundaries
36 complete resection
37 complete tumor resection
38 complications
39 conditions
40 confirmation
41 elapsed time
42 endocrinological function
43 endonasal transsphenoidal surgery
44 endoscopic endonasal transsphenoidal surgery
45 endoscopic transsphenoidal surgery
46 endoscopy
47 fluorescence
48 fluorescence endoscopy
49 fluorescent signal
50 function
51 gland
52 identification
53 internal carotid artery
54 interval
55 low fluorescence background
56 method
57 min
58 more tumors
59 normal pituitary gland
60 operation
61 patients
62 pituitary adenomas
63 pituitary gland
64 rate
65 resection
66 resection rate
67 signals
68 size
69 structure
70 study
71 such surgery
72 surgery
73 time
74 tool
75 transsphenoidal surgery
76 traps
77 tricks
78 tumor resection
79 tumor size
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81 useful tool
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83 vital structures
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