Tumors of female reproductive systemTumors of female reproductive systemОпухоли женской репродуктивной системы1994-40981999-8627Publishing House ABV Press128210.17650/1994-4098-2024-20-3-99-107GYNECOLOGY. CLINICAL CASEГИНЕКОЛОГИЯ. КЛИНИЧЕСКИЙ СЛУЧАЙIntraoperative ICG-fluorescence imaging of ureteral defect: case report and literature reviewИнтраоперационная визуализация дефекта мочеточника с использованием ICG-флуоресценции: клинический случай и обзор литературыhttps://orcid.org/0000-0003-1140-6578SmirnovaO. A.СмирноваО. А.
Russian Federation

Olga Alekseevna Smirnova

68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758

Ольга Алексеевна Смирнова

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

ssmirnova.oa@gmail.comhttps://orcid.org/0000-0002-8067-9150RumyantsevaD. I.РумянцеваД. И.
Russian Federation

68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

https://orcid.org/0009-0008-3530-887XTrifanovYu. N.ТрифановЮ. Н.
Russian Federation

68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

https://orcid.org/0000-0002-1593-6771YakovlevaM. G.ЯковлеваМ. Г.
Russian Federation

68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

https://orcid.org/0000-0002-1877-8852TyatkovS. A.ТятьковС. А.
Russian Federation

68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

https://orcid.org/0000-0003-3850-7109NosovA. K.НосовА. К.
Russian Federation

68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

https://orcid.org/0000-0001-6937-2740BerlevI. V.БерлевИ. В.
Russian Federation

68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова» Минздрава России09112024203991070911202409112024https://ojrs.abvpress.ru/ojrs/article/view/1282

Iatrogenic ureteral injury is the most frequent trauma during pelvic surgery. Due to the peculiarities of this topographic region, assessment of ureteral wall perfusion is critical for prevention of ischemic complications.

In modern surgical practice, assessing local ureteral perfusion is often based on the surgeon’s subjective opinion. Intraoperative angiography with indocyanine green (indocyanine green, ICG) has been shown to be an adequate reflection of tissue perfusion and potentially influence the outcome of surgery.

Currently, there are insufficient data regarding the use of ICG in iatrogenic ureteral injury. In this article, we describe a successful ICG fluorescence-guided middle third ureteroplasty in a 92-year-old patient with uterine cancer who underwent a simple hysterectomy. We also review the literature on this topic. The literature search for the review was performed using the PubMed database.

Based on currently available data, the use of ICG for defect detection and control during ureteral resection is feasible and safe. However, the significance of this procedure should be evaluated in further studies.

Наиболее частой травмой при операциях на тазовых органах является ятрогенное повреждение мочеточников. Оценка перфузии стенки мочеточников имеет решающее значение в профилактике ишемических осложнений, учитывая особенности данной топографической области.

В современной хирургической практике оценка местного кровоснабжения мочеточника часто основывается на субъективном мнении хирурга. Было доказано, что интраоперационная ангиография с индоцианином зеленым (indocyanine green, ICG) в достаточной степени отражает перфузию тканей и потенциально влияет на исход оперативного вмешательства.

В настоящее время имеются скудные данные об использовании ICG при ятрогенной травме мочеточника. В данной статье мы описываем успешную пластику средней трети мочеточника с использованием ICG-флуоресценции у 92-летней больной раком тела матки, перенесшей экстирпацию матки с придатками. Также мы приводим обзор литературы по данному вопросу. Поиск литературы для обзора осуществлялся с использованием базы данных PubMed. На основании имеющихся на сегодняшний день данных использование ICG для определения дефекта и контроля пластики мочеточника возможно и безопасно. Однако значимость данной процедуры должна быть оценена в дальнейших исследованиях.

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