Peritoneal contamination with ICG-stained cervical secretion as surrogate for potential cervical cancer tumor cell dissemination: A proof-of-principle study for laparoscopic hysterectomy.
Adult
Aged
Cohort Studies
Colpotomy
/ adverse effects
Female
Follow-Up Studies
Humans
Hysterectomy
/ adverse effects
Indocyanine Green
/ adverse effects
Intraoperative Complications
/ etiology
Laparoscopy
/ adverse effects
Middle Aged
Neoplasm Invasiveness
/ pathology
Neoplasm Staging
Peritoneal Cavity
/ physiopathology
Prospective Studies
Risk Assessment
Treatment Outcome
Uterine Cervical Neoplasms
/ diagnostic imaging
cervical cancer
colpotomy
indocyaningreen
laparoscopy
radical hysterectomy
tumor cell dissemination
Journal
Acta obstetricia et gynecologica Scandinavica
ISSN: 1600-0412
Titre abrégé: Acta Obstet Gynecol Scand
Pays: United States
ID NLM: 0370343
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
01
05
2019
revised:
26
05
2019
accepted:
18
06
2019
pubmed:
27
6
2019
medline:
1
4
2020
entrez:
27
6
2019
Statut:
ppublish
Résumé
Intracorporal colpotomy during radical hysterectomy for cervical cancer is discussed to be a risk factor for peritoneal dissemination of tumor cells. It might lead to increased recurrence rates after laparoscopic radical hysterectomy compared with abdominal hysterectomy, as shown by the recent LACC study. Data on the frequency or mechanisms of peritoneal contamination are missing. We aimed to analyze peritoneal contamination of cervical secretion during intracorporal colpotomy with a novel indocyaningreen (ICG)-based technique. In this prospective proof-of-principle study, patients undergoing routine laparoscopic or robot-assisted hysterectomy were selected. ICG was specifically applied to the cervical surface and routine surgery was performed. During colpotomy, pictures under white and fluorescence light were taken to evaluate frequency of contamination. By using cervically applied ICG we were able to visualize directly peritoneal contamination with cervical secretion during intracorporal colpotomy. We detected peritoneal contamination in 9/12 (75%) patients undergoing routine laparoscopic hysterectomy. Contamination of laparoscopic instruments occurred in 60% of the patients. When contamination occurred, it was routinely detectable during all steps of colpotomy. There were no adverse effects during surgery. Peritoneal contamination with cervical secretion frequently occurs during intracorporal colpotomy. This novel technique represents a promising tool for feasible and direct visualization of peritoneal contamination during colpotomy. The technique may be easily implemented in further studies on laparoscopic and abdominal hysterectomy and serve as a quality assessment tool for surgeons and surgical techniques.
Substances chimiques
Indocyanine Green
IX6J1063HV
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1398-1403Informations de copyright
© 2019 Nordic Federation of Societies of Obstetrics and Gynecology.
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