Abstract：
The main objective of this study was to review and perform a meta-analysis of current literature on the use of indocyanine green for sentinel lymph node detection in pelvic gynecologic cancer. We included all studies focusing on indications and procedures associated with the use of ICG in gynecologic surgery and available on the Medline and Pubmed database. For the meta-analysis, random effect models were used for estimation of the 95 % detection rate and 95 % confidence interval, and stratified analyses by cancer type, concentration and localization of injection were performed. A total of 147 articles were included, of which 91 were studied in a meta-analysis. Results concerning detection rate by indocyanine green injection site were found to be 95.1 % and 97.3 % respectively for intracervical injection in 2 or 4 quadrants, and 77.0 % and 94.8 % for hysteroscopic and intradermal injection respectively. Results concerning detection rate by cancer type were 95.8 %, 95.2 %, 94.7 % and 95.7 % respectively for cervical, endometrial, vulvar and endometrial/cervical cancers. Finally, the results concerning detection rate by indocyanine green concentration were 91.2 %, 95.7 %, 96.7 % and 97.7 % for concentrations of <1.25 mg/ml, 1.25 mg/ml, 2.5 mg/ml and 5 mg/ml respectively. In conclusion, indocyanine green is shown to allow highlighting of sentinel lymph nodes with good reliability with an overall indocyanine green detection rate of 95.5 %. Our literature review revealed that indocyanine green feasibility has also been demonstrated in several surgical contexts, notably for reconstructive surgery and detection of endometriosis.
摘要：
这项研究的主要目的是回顾并对有关吲哚菁绿用于盆腔妇科癌症前哨淋巴结检测的现有文献进行荟萃分析。我们纳入了所有研究，重点是与在妇科手术中使用ICG相关的适应症和程序，并可在Medline和Pubmed数据库中获得。对于荟萃分析，随机效应模型用于估计95%检出率和95%置信区间，按癌症类型进行分层分析，进行注射的浓度和定位。共收录147篇文章,其中91人在荟萃分析中进行了研究。结果发现，在2或4个象限的宫颈内注射中，吲哚菁绿注射部位的检出率分别为95.1％和97.3％。宫腔镜和皮内注射分别为77.0%和94.8%。结果按癌症类型的检出率为95.8％，95.2%,宫颈分别为94.7％和95.7％，子宫内膜,外阴和子宫内膜/宫颈癌。最后,吲哚菁绿浓度检出率为91.2%，95.7%,浓度<1.25mg/ml时为96.7%和97.7%，1.25mg/ml,分别为2.5mg/ml和5mg/ml。总之,吲哚菁绿显示出具有良好可靠性的前哨淋巴结突出显示，总吲哚菁绿检出率为95.5％。我们的文献综述显示，吲哚菁绿的可行性也已在几种手术环境中得到证实，特别是用于重建手术和子宫内膜异位症的检测。
