Brain & spine · 2026
Continuous white-light/indocyanine green overlay endoscopy in pituitary adenoma surgery: A prospective feasibility and safety study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Olesrud Ida, Andersen Martin K, Larsson Christopher, Heck Ansgar, Dahlberg Daniel, Wiedmann Markus K H
Аннотация
INTRODUCTION: Intraoperative differentiation between pituitary adenoma (PA) and normal gland tissue remains a key challenge in endoscopic transsphenoidal surgery (ETSS). Indocyanine green fluorescence (ICG-FL) has been proposed as a visual adjunct. Existing data are limited and primarily based on first-generation systems requiring intermittent mode switching.
RESEARCH QUESTION: Is implementation of a second-generation ICG endoscope with continuous white-light/near-infrared (WL/NIR) overlay safe and feasible in routine PA surgery?
MATERIALS AND METHODS: This prospective single-center observational study included consecutive patients undergoing ETSS for PA over a 28-month period. A second-generation ICG-FL endoscope with continuous WL/NIR overlay visualization was used throughout tumor resection. Primary endpoints were adverse events related to ICG-administration or device use. Secondary endpoints included surgical complications, short-term endocrine outcome and radiological residual tumor.
RESULTS: After screening, 130 patients met inclusion criteria. Continuous WL/NIR overlay was successfully applied in all cases without intraoperative technical failure, dye-related adverse events, or need to revert to white-light-only visualization. Among functional PAs, 75% (52/69) achieved early biochemical remission. At follow-up, 22 patients (17%) had radiologically confirmed residual tumor, while 73 (56%) showed no residual disease. When combined with functional cases not undergoing MRI due to confirmed remission (n = 27), extrapolated gross-total resection was 77%.
DISCUSSION AND CONCLUSIONS: Continuous ICG-FL guidance was safe and feasible in routine ETSS for PA, without compromising surgical workflow, anatomical visualization, or requiring conversion to white-light-only endoscopy. Complication rates were consistent with contemporary endoscopic series. Continuous fluorescence provides real-time perfusion information that may facilitate improved tissue differentiation and warrants further comparative evaluation.
RESEARCH QUESTION: Is implementation of a second-generation ICG endoscope with continuous white-light/near-infrared (WL/NIR) overlay safe and feasible in routine PA surgery?
MATERIALS AND METHODS: This prospective single-center observational study included consecutive patients undergoing ETSS for PA over a 28-month period. A second-generation ICG-FL endoscope with continuous WL/NIR overlay visualization was used throughout tumor resection. Primary endpoints were adverse events related to ICG-administration or device use. Secondary endpoints included surgical complications, short-term endocrine outcome and radiological residual tumor.
RESULTS: After screening, 130 patients met inclusion criteria. Continuous WL/NIR overlay was successfully applied in all cases without intraoperative technical failure, dye-related adverse events, or need to revert to white-light-only visualization. Among functional PAs, 75% (52/69) achieved early biochemical remission. At follow-up, 22 patients (17%) had radiologically confirmed residual tumor, while 73 (56%) showed no residual disease. When combined with functional cases not undergoing MRI due to confirmed remission (n = 27), extrapolated gross-total resection was 77%.
DISCUSSION AND CONCLUSIONS: Continuous ICG-FL guidance was safe and feasible in routine ETSS for PA, without compromising surgical workflow, anatomical visualization, or requiring conversion to white-light-only endoscopy. Complication rates were consistent with contemporary endoscopic series. Continuous fluorescence provides real-time perfusion information that may facilitate improved tissue differentiation and warrants further comparative evaluation.