Abstract
BackgroundWe investigated the safety and feasibility of intraoperative near‐infrared (NIR) imaging using indocyanine green (ICG) during sympathectomy in the management of primary palmar hyperhidrosis (PPH).MethodsWe performed a retrospective review of 142 patients (ICG group) who underwent endoscopic thoracic sympathectomy (ETS) between February 2018 and April 2019. All patients received a 5 mg/kg infusion of ICG 24 hours preoperatively. The vital signs before and after ICG injection and adverse reactions were recorded. Meanwhile, 498 patients (Non‐ICG group) who underwent ETS by normal thoracoscopy during August 2017 to April 2019 were also reviewed to compare the abnormal white blood cell (WBC) counts, alanine transaminase (ALT), aspartate transaminase (AST), blood urea nitrogen (BUN), and creatinine (Cr) levels before and after operation between two groups.ResultsFor ICG group, the vital signs including body temperature, heart rate and blood pressure before and after ICG injection were stable. There was no significant difference in the abnormal WBC counts, ALT, AST, BUN, and Cr levels before and after operation between two groups. Only one patient had mild adverse reaction (0.7%) after ICG injection. The visibility rate of all sympathetic ganglions was 96.7% (1369/1415). The visibility rate from T1 to T5 was 98.23% (278/283), 98.23% (278/283), 97.17% (275/283), 95.76% (271/283), and 94.35% (267/283), respectively. There was no significant difference in the visibility rate with regard to age, gender, height, weight, body mass index, and PPH grade.ConclusionsNIR fluorescence imaging with ICG for identifying sympathetic ganglions is relatively safe and feasible.Key points• Significant findings of the study. NIR fluorescence imaging with ICG for identifying sympathetic ganglions is relatively safe and feasible.• What this study adds.This technology may take the place of the rib‐oriented method as standard practice for the precise localization of sympathetic ganglions, and may improve the effect of sympathectomies.
Highlights
Primary palmar hyperhidrosis (PPH) is a disorder characterized by excessive sweating which can cause significant professional and social handicaps
The results and side effects of this procedure vary between patients
To better evaluate the safety of intraoperative NIR fluorescence imaging with indocyanine green (ICG) in thoracoscopic sympathectomy for PPH, we reviewed the files of 498 patients who had undergone endoscopic thoracic sympathectomy (ETS) by normal thoracoscopy from August 2017 to April 2019
Summary
Primary palmar hyperhidrosis (PPH) is a disorder characterized by excessive sweating which can cause significant professional and social handicaps. Intraoperative nearinfrared (NIR) fluorescence imaging with indocyanine green (ICG) has been used for many thoracic surgeries. The primary objective of this study was to demonstrate the safety and feasibility of intraoperative NIR imaging using ICG during sympathectomy in the management of primary palmar hyperhidrosis. We investigated the safety and feasibility of intraoperative nearinfrared (NIR) imaging using indocyanine green (ICG) during sympathectomy in the management of primary palmar hyperhidrosis (PPH). Methods: We performed a retrospective review of 142 patients (ICG group) who underwent endoscopic thoracic sympathectomy (ETS) between February 2018 and April 2019. 498 patients (Non-ICG group) who underwent ETS by normal thoracoscopy during August 2017 to April 2019 were reviewed to compare the abnormal white blood cell (WBC) counts, alanine transaminase (ALT), aspartate transaminase (AST), blood urea nitrogen (BUN), and creatinine (Cr) levels before and after operation between two groups. Conclusions: NIR fluorescence imaging with ICG for identifying sympathetic ganglions is relatively safe and feasible
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