1
|
Lim ZY, Mohan S, Balasubramaniam S, Ahmed S, Siew CCH, Shelat VG. Indocyanine green dye and its application in gastrointestinal surgery: The future is bright green. World J Gastrointest Surg 2023; 15:1841-1857. [PMID: 37901741 PMCID: PMC10600780 DOI: 10.4240/wjgs.v15.i9.1841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/17/2023] [Accepted: 07/31/2023] [Indexed: 09/21/2023] Open
Abstract
Indocyanine green (ICG) is a water-soluble fluorescent dye that is minimally toxic and widely used in gastrointestinal surgery. ICG facilitates anatomical identification of structures (e.g., ureters), assessment of lymph nodes, biliary mapping, organ perfusion and anastomosis assessment, and aids in determining the adequacy of oncological margins. In addition, ICG can be conjugated to artificially created antibodies for tumour markers, such as carcinoembryonic antigen for colorectal, breast, lung, and gastric cancer, prostate-specific antigen for prostate cancer, and cancer antigen 125 for ovarian cancer. Although ICG has shown promising results, the optimization of patient factors, dye factors, equipment, and the method of assessing fluorescence intensity could further enhance its utility. This review summarizes the clinical application of ICG in gastrointestinal surgery and discusses the emergence of novel dyes such as ZW-800 and VM678 that have demonstrated appropriate pharmacokinetic properties and improved target-to-background ratios in animal studies. With the emergence of robotic technology and the increasing reporting of ICG utility, a comprehensive review of clinical application of ICG in gastrointestinal surgery is timely and this review serves that aim.
Collapse
Affiliation(s)
- Zavier Yongxuan Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Swetha Mohan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | | | - Saleem Ahmed
- Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | | | - Vishal G Shelat
- Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
| |
Collapse
|
2
|
Reyes-Jaimes L, Camacho-Aguilera JF. [Spontaneous splenic rupture. Case report and literature review]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:523-531. [PMID: 37540732 PMCID: PMC10484555 DOI: 10.5281/zenodo.8200591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/04/2023] [Indexed: 08/06/2023]
Abstract
Background Spontaneous splenic rupture is often life threatening due to delay in diagnosis and treatment. Abdominal pain, Kehr's sign, nausea, bloating, altered consciousness, and intestinal obstruction may be present. In larger splenic lesions, signs of peritonitis and hypovolemic shock are present. Contrast-enhanced computed tomography is the election study. Diagnosis is confirmed by negative viral serology and normal spleen on gross and histopathologic inspection. The most frequent treatment in splenectomy. Clinic case A 30-year-old male with no medical history presented with generalized abdominal pain accompanied by Kehr's sign. He is diagnosed with ruptured spleen by contrast-enhanced computed tomography and successfully treated with splenectomy. He was discharged 6 days after surgery. Conclusions Spontaneous rupture of the spleen is uncommon, but with high morbidity and mortality. It must be a differential diagnosis in the face of abdominal and/or chest pain, and the corresponding imaging studies should be carried out if the patient's conditions allow it, or their search during an exploratory laparotomy.
Collapse
Affiliation(s)
- Libertad Reyes-Jaimes
- Instituto Mexicano del Seguro Social, Hospital General de Zona No. 3, Servicio de Cirugía General. San Juan del Río, Querétaro, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - José Francisco Camacho-Aguilera
- Instituto Mexicano del Seguro Social, Hospital General de Zona No. 3, Servicio de Cirugía General. San Juan del Río, Querétaro, MéxicoInstituto Mexicano del Seguro SocialMéxico
| |
Collapse
|
3
|
Chu Y, Xu F, Ren Z, Hu X, Wang L, Yue J. Splenic Metastatic Choriocarcinoma with Nontraumatic Splenic Rupture: A Case Report and Literature Review. J Clin Med 2022; 12:jcm12010157. [PMID: 36614958 PMCID: PMC9821716 DOI: 10.3390/jcm12010157] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/16/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
Choriocarcinoma is a highly malignant trophoblastic tumor that occurs mostly in women of childbearing age. The main mode of metastasis is hematogenous metastasis. The most common sites of metastasis are the lung, vagina and brain, while splenic metastasis is rare. Because of its rapid development, extensive metastasis can occur in a short period, and some patients only show metastatic symptoms, which are often missed or misdiagnosed as ectopic pregnancy or other diseases. We describe a rare case of splenic metastatic choriocarcinoma with acute abdominal pain caused by nontraumatic splenic rupture. In addition, we review the previous literature on splenic metastasis of choriocarcinoma and summarize the clinical manifestations, management measures and prognoses. Our case and literature review indicate that splenic metastatic choriocarcinoma is rare and difficult to distinguish from splenic ectopic pregnancy and other diseases. Clinicians should strengthen their understanding of this disease and avoid misdiagnosis.
Collapse
Affiliation(s)
- Yifan Chu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Fulan Xu
- Department of Obstetrics and Gynecology, Xiaogan Hospital, Wuhan University of Science and Technology, Xiaogan 432000, China
| | - Zhengguang Ren
- Department of Clinical Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Xinyao Hu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Luyao Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Jing Yue
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China
- Correspondence: ; Tel.: +86-27-8366-2534
| |
Collapse
|
4
|
Tan M, Low HM, Shelat V, Tan CH. Imaging patterns in non-traumatic spleen lesions in adults-a review. Jpn J Radiol 2022; 40:664-677. [PMID: 35099683 DOI: 10.1007/s11604-022-01250-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 01/17/2022] [Indexed: 02/05/2023]
Abstract
The spleen is a complex organ involved in multiple physiological processes in the human body. Elective splenectomy is an uncommon operation, and the precise characterization of the lesion should be achieved to determine the risks and benefits of this operation accurately. Given the significant role of the spleen in homeostasis and the potential risks of the surgery itself and following sequelae such as infection susceptibility, accurate recognition, and classification of splenic lesions is required before surgery. This review provides an overview of malignant (e.g., lymphoma, angiosarcoma) and benign (e.g., cysts, hemangioma, hamartoma) splenic lesions that may warrant an elective splenectomy. Images from a cohort of adult patients undergoing isolated splenectomy for non-traumatic indications in a single center are provided. This review highlights the considerable overlap in imaging patterns between splenic lesions, splenic lesions masquerading as lesions in other organs, increased detection of asymptomatic splenic incidentalomas due to improvements in imaging modalities. This review also provides clinical correlations for each lesion, providing additional information to help clinicians differentiate between lesions and accurately identify diseases amenable to surgical management.
Collapse
Affiliation(s)
| | - Hsien Min Low
- Department of Radiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Vishalkumar Shelat
- Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
| | - Cher Heng Tan
- Department of Radiology, Tan Tock Seng Hospital, Singapore, Singapore
| |
Collapse
|
5
|
Abstract
Introduction: Spleen angiosarcoma (SA) is a rare malignant neoplasm that arises from the splenic vascular endothelium, with only around 300 cases reported to date. Due to a limited number of reported cases, there is a paucity of data and a lack of understanding of its presentation, diagnosis, and management. In this study, we aim to provide a comprehensive review of SA.Areas covered: On 27 February 2021, a literature search was done in PubMed and Embase database. The search yielded 122 articles involving 205 patients. The focus was on patient demographics, risk factors, clinical presentations, investigation results, preliminary diagnoses, therapies provided, and patient outcomes. These factors were analyzed to identify possible risk factors, diagnostic modalities, and therapeutic principles that were not mentioned before.Expert opinion: The clinical presentation or investigation results of patients with SA are often nonspecific. Hence, they may not be sufficient to clinch the diagnosis of SA if used alone. The authors recommend a triple assessment of clinical examination, imaging findings, and pathology to diagnose SA with high accuracy. Splenectomy should be the mainstay of management, with chemotherapy and radiotherapy considered as adjuncts, especially in the presence of metastases.
Collapse
|
6
|
Zhang J, Bi X, Xin Q, Zhang A. Ultra-high-risk choriocarcinoma with atraumatic splenic rupture: a rare case report. J Int Med Res 2021; 49:3000605211033222. [PMID: 34340579 PMCID: PMC8358583 DOI: 10.1177/03000605211033222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Choriocarcinoma is a malignant tumor associated with early vascular invasion and a high mortality. Ultra-high-risk choriocarcinoma, which was proposed in the International Federation of Gynecology and Obstetrics cancer report of 2018, has a higher risk of treatment failure and a worse prognosis than choriocarcinoma. We report a rare case of a 39-year-old female patient with ultra-high-risk choriocarcinoma (stage IV:20) with hemorrhage secondary to atraumatic splenic rupture as the initial sign. A satisfactory outcome was achieved through comprehensive treatment with surgery, chemotherapy, immunotherapy, and targeted therapy.
Collapse
Affiliation(s)
- Jun Zhang
- Department of Gynecology, 74672Tianjin Third Central Hospital, The Tianjin Third Central Hospital, The Third Central Clinical College of Tianjin Medical University, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
| | - Xinchun Bi
- Department of Gynecology, 74672Tianjin Third Central Hospital, The Tianjin Third Central Hospital, The Third Central Clinical College of Tianjin Medical University, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
| | - Qi Xin
- Department of Pathology, 74672Tianjin Third Central Hospital, The Tianjin Third Central Hospital, The Third Central Clinical College of Tianjin Medical University, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
| | - Aihua Zhang
- Department of Gynecology, 74672Tianjin Third Central Hospital, The Tianjin Third Central Hospital, The Third Central Clinical College of Tianjin Medical University, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
| |
Collapse
|
7
|
Luu DT, Duc NM, My TTT, Giang TV, Bang LV, Lenh BV. An Extremely Rare Case of Splenic Rupture Secondary to Metastatic Gestational Choriocarcinoma. World J Oncol 2021; 12:39-43. [PMID: 33738005 PMCID: PMC7935620 DOI: 10.14740/wjon1356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/01/2021] [Indexed: 11/11/2022] Open
Abstract
Gestational choriocarcinoma (GC) is an uncommon malignant tumor consisting of trophoblastic cells. The lungs, liver, and central nervous system are the most common metastatic sites for this disease. However, splenic metastasis is unusual and might result in spontaneous rupture. Symptoms associated with splenic rupture may be the first presentation of malignancy. A thorough medical history and examination are necessary to detect the primary lesion. Herein, we present a case of a 23-year-old female who had splenic rupture secondary to choriocarcinoma metastasis. Although the emergency condition had been solved, the patient died 1 month after due to brain metastasis. The goal of this article was to report a new case of spontaneous splenic rupture caused by choriocarcinoma metastasis and to review the existing literature on splenic metastases associated with GC, including the epidemiology and etiology.
Collapse
Affiliation(s)
- Doan Tien Luu
- Department of Radiology, Ha Noi Medical University Hospital, Ha Noi, Vietnam.,Department of Radiology, Ha Noi Medical University, Ha Noi, Vietnam.,These authors contributed equally as co-first authors
| | - Nguyen Minh Duc
- Department of Radiology, Ha Noi Medical University, Ha Noi, Vietnam.,Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.,Department of Radiology, Children's Hospital 2, Ho Chi Minh City, Vietnam.,These authors contributed equally as co-first authors
| | - Thieu-Thi Tra My
- Department of Radiology, Ha Noi Medical University, Ha Noi, Vietnam
| | - Tran-Van Giang
- Department of Radiology, Ha Noi Medical University, Ha Noi, Vietnam
| | - Luong Viet Bang
- Department of Pathology, Tam Anh General Hospital, Ha Noi, Vietnam
| | - Bui-Van Lenh
- Department of Radiology, Ha Noi Medical University Hospital, Ha Noi, Vietnam.,Department of Radiology, Ha Noi Medical University, Ha Noi, Vietnam
| |
Collapse
|