ICG导航在儿童卵巢畸胎瘤保留器官切除术中的应用

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这篇文章展示了首次使用吲哚菁绿（Indocyanine green）来观察女孩卵巢肿瘤的经验。这表明， 新成像技术的发展会改变这种病理的治疗。

我们在该研究中对两名年龄分别为12岁和15岁的患有卵巢畸胎瘤女孩的病史进行了回顾性分析。这两名女孩因下腹不舒服和疼痛而就医。腹部超声检查和计算机断层扫描诊断出肿瘤，其大小分别为40×42×38和60×54×38毫米。一个女孩的肿瘤在她的右卵巢，另一个在她的左卵巢。癌症标志 物（甲胎蛋白、β-人绒毛膜促性腺激素和癌抗原125）浓度没有升高。诊断为卵巢畸胎瘤的手术是在腹腔镜下进行的，并有透视控制。吲哚菁绿成像技术的使用有效地确定了肿瘤和健康卵巢组织的边界。这使得保留器官手术得以进行。在手术过程中，没有出现卵巢实质出血或邻近器官损伤的并发症。通过组织学检查，这些肿瘤被确定为成熟性畸胎瘤。住院时间为3天。术后6个月的超声检查时没有发现疾病复发的症状。观察到一名患者的卵巢组织再生，其大小与对侧卵巢相当。对于另一个女孩来说，受影响的卵巢大约只有对侧卵巢的一半大小。

因此，对儿童卵巢畸胎瘤进行的保留器官手术治疗可以说是首选方法。一个基本的创新是使用吲哚菁绿荧光技术来确定肿瘤扩散的边界，以便在健康组织内切除肿瘤。

作者简介

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 代码: 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

俄罗斯联邦, Irkutsk; Irkutsk; Irkutsk

Simon 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

俄罗斯联邦, Irkutsk; Irkutsk

Andrei A. Marchuk

Children’s Regional Clinical Hospital

Email: maa-ped20@yandex.ru
ORCID iD: 0000-0001-9767-0454

surgeon

俄罗斯联邦, Irkutsk

Alexander P. Rozhanskii

Irkutsk State Medical University

Email: alexanderozhanski@mail.ru
ORCID iD: 0000-0001-7922-7600
SPIN 代码: 4012-7120

surgical resident

俄罗斯联邦, Irkutsk

Anton A. Byrgazov

Irkutsk State Medical University

Email: byrgazov.ant-doc38@yandex.ru
ORCID iD: 0000-0002-9195-5480

radiologist

俄罗斯联邦, Irkutsk

Sergey A. Muravev

Irkutsk State Medical University

Email: muravev1999sergey@mail.ru
ORCID iD: 0000-0003-4731-7526

6th year student

俄罗斯联邦, Irkutsk

Konstantin 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 代码: 3965-6284

Cand. Sci. (Med.); assistant professor; head of pediatric surgery

俄罗斯联邦, Kemerovo; Kemerovo

Vadim 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

以色列, Ashdod

Artem N. Narkevich

V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University

编辑信件的主要联系方式.
Email: narkevichart@gmail.com
ORCID iD: 0000-0002-1489-5058
SPIN 代码: 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

俄罗斯联邦, Krasnoyarsk

参考

  1. Szymon O, Bogusz B, Taczanowska-Niemczuk A, et al. Ovarian sparing surgery in mature ovarian teratomas in children: A 20-year single-center experience. Eur J Pediatr Surg. 2021;31(1):2–7. doi: 10.1055/s-0040-1716877
  2. Al Jama FE, Al Ghamdi AA, Gasim T, et al. Ovarian tumors in children and adolescents — a clinical study of 52 patients in a university hospital. J Pediatr Adolesc Gynecol. 2011;24(1):25–28. doi: 10.1016/j.jpag.2010.06.005
  3. Takayasu H, Masumoto K, Tanaka N, et al. A clinical review of ovarian tumors in children and adolescents. Pediatr Surg Int. 2020;36(6):701–709. doi: 10.1007/s00383-020-04660-w
  4. Esposito C, Coppola V, Cerulo M, et al. Review of a 25-year experience in the management of ovarian masses in neonates, children and adolescents: From laparoscopy to robotics and indocyanine green fluorescence technology. Children (Basel). 2022;9(8):1219. doi: 10.3390/children9081219
  5. Haadsma ML, Mooij TM, Groen H, et al. A reduced size of the ovarian follicle pool is associated with an increased risk of a trisomic pregnancy in IVF-treated women. Hum Reprod. 2010;25(2):552–558. doi: 10.1093/humrep/dep404
  6. Rosendahl M, Simonsen MK, Kjer JJ. The influence of unilateral oophorectomy on the age of menopause. Climacteric. 2017;20(6):540–544. doi: 10.1080/13697137.2017.1369512
  7. Gkrozou F, Tsonis O, Vatopoulou A, et al. Ovarian teratomas in children and adolescents: Our own experience and review of literature. Children (Basel). 2022;9(10):1571. doi: 10.3390/children9101571
  8. Paraboschi I, De Coppi P, Stoyanov D, et al. Fluorescence imaging in pediatric surgery: State-of-the-art and future perspectives. J Pediatr Surg. 2021;56(4):655–662. doi: 10.1016/j.jpedsurg.2020.08.004
  9. Alghoul H, Al Farajat F, Alser O, et al. Intraoperative uses of near-infrared fluorescence spectroscopy in pediatric surgery: A systematic review. J Pediatr Surg. 2022;57(6):1137–1144. doi: 10.1016/j.jpedsurg.2022.01.039
  10. Lindfors O. Primary ovarian neoplasms in infants and children. A study of 81 cases diagnosed in Finland and Sweden. Ann Chir Gynaecol Fenn Suppl. 1971;177:1–66.
  11. Martelli H, Patte C. Gonadal tumours in children. Arch Pediatr. 2003;10(3):246–250. doi: 10.1016/S0929-693X(03)00038-1
  12. Anton-Păduraru D-T, Miron IC, Lupu VV, et al. Ovarian teratoma in a teenager causing ureterohydronephrosis: Case report and literature review. Medicine (Baltimore). 2021;100(27):e26472. doi: 10.1097/MD.0000000000026472
  13. Outwater EK, Siegelman ES, Hunt JL. Ovarian teratomas: tumor types and imaging characteristics. Radiographics. 2001;21(2):475–490. doi: 10.1148/radiographics.21.2.g01mr09475
  14. Oosterhuis JW, Looijenga LH, van Echten J, de Jong B. Chromosomal constitution and developmental potential of human germ cell tumors and teratomas. Cancer Genet Cytogenet. 1997;95(1):96–102. doi: 10.1016/s0165-4608(96)00275-0
  15. Spinelli C, Pucci V, Strambi S, et al. Treatment of ovarian lesions in children and adolescents: a retrospective study of 130 cases. Pediatr Hematol Oncol. 2015;32(3):199–206. doi: 10.3109/08880018.2013.856050
  16. Sarnacki S, Brisse H. Surgery of ovarian tumors in children. Horm Res Paediatr. 2011;75(3):220–224. doi: 10.1159/000322829
  17. Spinelli C, Pucci V, Buti I, et al. The role of tumor markers in the surgical approach of ovarian masses in pediatric age: a 10-year study and a literature review. Ann Surg Oncol. 2012;19(6):1766–1773. doi: 10.1245/s10434-012-2249-y
  18. Elgendy A, Lakshminarayanan B, Elrouby A, et al. Management of pediatric benign ovarian tumors in England and Egypt: A comparative study. Afr J Paediatr Surg. 2020;17(1-2):33–38. doi: 10.4103/ajps.AJPS_64_20
  19. Michelotti B, Segura BJ, Sau I, et al. Surgical management of ovarian disease in infants, children, and adolescents: a 15-year review. J Laparoendosc Adv Surg Tech A. 2010;20(3):261–264. doi: 10.1089/lap.2009.0137
  20. Kaijser J, Bourne T, Valentin L, et al. Improving strategies for diagnosing ovarian cancer: a summary of the International Ovarian Tumor Analysis (IOTA) studies. Ultrasound Obstet Gynecol. 2013;41(1):9–20. doi: 10.1002/uog.12323
  21. Terzic M, Rapisarda AMC, Della Corte L, et al. Diagnostic work-up in paediatric and adolescent patients with adnexal masses: an evidence-based approach. J Obstet Gynaecol. 2021;41(4):503–515. doi: 10.1080/01443615.2020.1755625
  22. Renaud EJ, Sømme S, Islam S, et al. Ovarian masses in the child and adolescent: An American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee systematic review. J Pediatr Surg. 2019;54(3):369–377. doi: 10.1016/j.jpedsurg.2018.08.058
  23. Hayes-Jordan A. Surgical management of the incidentally identified ovarian mass. Semin Pediatr Surg. 2005;14(2):106–110. doi: 10.1053/j.sempedsurg.2005.01.006
  24. Rousseau V, Massicot R, Darwish AA, et al. Emergency management and conservative surgery of ovarian torsion in children: a report of 40 cases. J Pediatr Adolesc Gynecol. 2008;21(4):201–206. doi: 10.1016/j.jpag.2007.11.003
  25. Gonzalez DO, Cooper JN, Aldrink JH, et al. Variability in surgical management of benign ovarian neoplasms in children. J Pediatr Surg. 2017;52(6):944–950. doi: 10.1016/j.jpedsurg.2017.03.014
  26. Hermans AJ, Kluivers KB, Wijnen MH, et al. Diagnosis and treatment of adnexal masses in children and adolescents. Obstet Gynecol. 2015;125(3):611–615. doi: 10.1097/AOG.0000000000000665
  27. Banlı-Cesur I, Tanrıdan-Okcu N, Özçelik Z. Ovarian masses in children and adolescents: Analysis on 146 patients. J Gynecol Obstet Hum Reprod. 2021;50(6):101901. doi: 10.1016/j.jogoh.2020.101901

补充文件

附件文件
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1. JATS XML
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2. Fig. 1. Computed tomography of the teratoma of the right ovary

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3. Fig. 2. ICG-NIRF imaging of ovarian teratoma in overlay mode

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4. Fig. 3. ICG-NIRF imaging of ovarian teratoma in monochrome mode

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5. Fig. 4. ICG-NIRF visualization of ovarian teratoma in color mapping mode

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