探讨静脉吲哚菁绿荧光成像(ICG-FI)在胸腔镜节段切除术中节段间平面可视化及围手术期结局是否优于传统的充气-放气方法(对照组)。我们搜索了PubMed,Embase,科克伦图书馆,EMBASE,万方数据库,VIP数据库,和CNKI数据库,包括侧重于ICG-FI和对照比较的比较研究,到2022年12月。我们使用标准均值差异(SMD,连续变量)或风险比(RR,分类变量)及其相应的95%置信区间(CI)用于评估合并效应。该分析是根据PRISMA指南进行的。总计,纳入了7项已发表的905例患者(ICG-FI组n=428,对照组n=477)进行进一步分析.ICG-FI组术中出血较少(SMD=-0.23,95%CI:-0.08~-0.38,P<0.05)。手术时间较短(SMD=-0.87,95%CI:-1.75~-0.17,P<0.05),节间边界线(IBL)呈现时间较短(SMD=-4.50,95%CI:-4.97~-4.07,P<0.01)。ICG-FI组术后住院时间较短(SMD=-0.18,95%CI:-0.34~-0.03),P<0.05),引流时间(SMD=-0.18,95%CI:-0.34~-0.03,P<0.05)优于对照组。ICG-FI组术后并发症也较少(RR=0.75,95%CI:0.64-0.88)。淋巴结切除数目差异无统计学意义。在这项分析中没有发现显著的发表偏倚。与通货膨胀-通货紧缩法相比,ICG-FI在胸腔镜肺段切除术中的应用可缩短手术时间,IBL演示时间,住院时间,术中失血,和总体并发症发生率。
To investigate whether the application of intravenous indocyanine green fluorescence imaging(ICG-FI) had advantage in intersegmental plane visualization and perioperative outcome than using traditional inflation-deflation method(control group) in thoracoscopic segmentectomy. We searched PubMed, Embase, Cochrane Library, EMBASE, Wanfang Database, VIP Database, and CNKI Database to include comparative studies focusing on the comparisons of ICG-FI and control, up to December 2022. We used standard mean differences (SMD, continuous variables) or risk ratios (RR, categorical variables) with their corresponding 95 % confidence interval (CI) were used to assess pooled effects. This analysis was conducted according to the PRISMA guideline. Total, seven published studies with 905 patients (ICG-FI group n = 428, control group n = 477) were included for further analysis. The ICG-FI group was significantly associated with less bleeding during the surgery (SMD = -0.23,95 % CI: -0.08∼-0.38, P < 0.05), shorter surgery time (SMD = -0.87, 95 % CI: -1.75∼-0.17, P < 0.05) and intersegmental boundary line (IBL) presentation time (SMD = -4.50, 95 % CI: -4.97∼-4.07, P < 0.01). The ICG-FI group had shorter postoperative hospitalization time (SMD = -0.18, 95 % CI: -0.34∼-0.03), P < 0.05), and the drainage duration (SMD = -0.18, 95 % CI: -0.34∼-0.03,P < 0.05) than that in the control group. The ICG-FI group also showed the less postoperative complications (RR = 0.75, 95 % CI: 0.64-0.88). There were no significant differences in the number of lymph node resection. No significant publication bias were found in this analysis. Compared with inflation-deflation method, application of ICG-FI in thoracoscopic segmentectomy could reduce operation time, IBL presentation time, length of hospital stay, intraoperative blood loss, and overall complication incidence.