Use of ICG navigation in organ-preserving resections of ovarian teratomas in children
- Authors: Kozlov Y.A.1,2,3, Poloyan S.S.1,3, Marchuk A.A.1, Rozhanskii A.P.3, Byrgazov A.A.3, Muravev S.A.3, Kovalkov K.A.4,5, Kapuller V.M.6, Narkevich A.N.7
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Affiliations:
- Children’s Regional Clinical Hospital
- Irkutsk State Medical Academy of Postgraduate Education
- Irkutsk State Medical University
- Yu.A. Atamanov Kuzbass Regional Children’s Hospital
- Kemerovo State Medical University
- Assuta University Medical Center, Ben-Gurion University of the Negev
- V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University
- Issue: Vol 13, No 2 (2023)
- Pages: 237-246
- Section: Case reports
- URL: https://journals.rcsi.science/2219-4061/article/view/132777
- DOI: https://doi.org/10.17816/psaic1503
- ID: 132777
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Abstract
This study presents the first experience of indocyanine green imaging for ovarian tumors in girls to show how the development of new imaging technologies can change the treatment of this pathology.
A retrospective analysis was conducted on the case histories of a 12-year-old girl and a 15-year-old girl with ovarian teratomas who were admitted with complaints of discomfort and pain in the lower abdomen. Ultrasound and computed tomography of the abdominal cavity revealed tumors with sizes of 40 × 42 × 38 and 60 × 54 × 38 mm in the right ovary for one girl and in the left ovary for the other girl. No increase in the concentration of tumor markers (alpha-fetoprotein, β-chorionic gonadotropin, and Cancer Antigen 125) was recorded. Operations for the diagnosis of ovarian teratoma were performed laparoscopically using fluoroscopic control. The use of indocyanine green imaging was effective in determining the boundaries of the tumor and healthy ovarian tissues, making it possible to perform organ-sparing surgery. During the surgical intervention, no complications were observed in the form of bleeding from the ovarian parenchyma or damage to neighboring organs. Histological diagnosis established that the neoplasms belong to mature teratomas. The length of hospital stay was three days. Ultrasound examination performed six months after surgery showed no signs of disease recurrence. One of the patients exhibited regeneration of ovarian tissues comparable with the size of the contralateral ovary. In another girl, the affected ovary was about half the size.
Thus, organ-preserving surgical treatment for ovarian teratomas in children is the method of choice. A fundamental innovation is the use of indocyanine green fluorescence technology to determine the boundaries of the spread of the tumor in order to resect it within healthy tissues.
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##article.viewOnOriginalSite##About the authors
Yury A. Kozlov
Children’s Regional Clinical Hospital; Irkutsk State Medical Academy of Postgraduate Education; Irkutsk State Medical University
Email: yuriherz@hotmail.com
ORCID iD: 0000-0003-2313-897X
SPIN-code: 3682-0832
Dr. Sci. (Med.), corresponding member of Russian Academy of Sciences; сhief; head of the Department of pediatrics and pediatric surgery; professor of the Department of pediatric surgery
Russian Federation, Irkutsk; Irkutsk; IrkutskSimon S. Poloyan
Children’s Regional Clinical Hospital; Irkutsk State Medical University
Email: simonpoloyan@ya.ru
ORCID iD: 0000-0001-7042-6646
head of pediatric surgery
Russian Federation, Irkutsk; IrkutskAndrei A. Marchuk
Children’s Regional Clinical Hospital
Email: maa-ped20@yandex.ru
ORCID iD: 0000-0001-9767-0454
surgeon
Russian Federation, IrkutskAlexander P. Rozhanskii
Irkutsk State Medical University
Email: alexanderozhanski@mail.ru
ORCID iD: 0000-0001-7922-7600
SPIN-code: 4012-7120
surgical resident
Russian Federation, IrkutskAnton A. Byrgazov
Irkutsk State Medical University
Email: byrgazov.ant-doc38@yandex.ru
ORCID iD: 0000-0002-9195-5480
radiologist
Russian Federation, IrkutskSergey A. Muravev
Irkutsk State Medical University
Email: muravev1999sergey@mail.ru
ORCID iD: 0000-0003-4731-7526
6th year student
Russian Federation, IrkutskKonstantin A. Kovalkov
Yu.A. Atamanov Kuzbass Regional Children’s Hospital; Kemerovo State Medical University
Email: gs-det-hirurg@kuzdrav.ru
ORCID iD: 0000-0001-6126-4198
SPIN-code: 3965-6284
Cand. Sci. (Med.); assistant professor; head of pediatric surgery
Russian Federation, Kemerovo; KemerovoVadim M. Kapuller
Assuta University Medical Center, Ben-Gurion University of the Negev
Email: kapuller@gmail.com
ORCID iD: 0000-0003-0076-5778
MD, head of Department of Pediatric Surgery
Israel, AshdodArtem N. Narkevich
V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University
Author for correspondence.
Email: narkevichart@gmail.com
ORCID iD: 0000-0002-1489-5058
SPIN-code: 9030-1493
Dr. Sci. (Med.), assistant professor, head of the Department of medical cybernetics and informatics, dean of the faculty of medicine, head of the laboratory of medical cybernetics and management in health care
Russian Federation, KrasnoyarskReferences
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