荧光引导手术（Fluorescence-guided surgery，简称FGS）在儿科肿瘤外科学中越来越多地应用了吲哚菁绿（Indocyanine green，简称ICG）。然而，FGS在大多数文献中仅报道了在肝脏和肾脏肿瘤的病例研究。在儿科肿瘤外科学中运用新技术比成人肿瘤外科学更具挑战性，原因在于肿瘤组织学、生物学的差异以及案例较少。目前还没有关于ICG引导的FGS在儿科实体肿瘤外科手术中的一致共识。因此，我们回顾了文献并讨论了FGS的局限性和前景。根据PRISMA指南，我们分析了关于ICG引导的儿童实体肿瘤FGS的文章。我们排除了病例报告、意见文章和评论综述。在分析的108篇文章中，有17篇（14篇回顾性研究和3篇前瞻性研究）符合纳入标准。大多数研究（70.6%）使用ICG来识别肝脏肿瘤，但ICG的给药时间和剂量各不相同。手术中结果、灵敏度和特异性报告在研究中占23.5%。荧光引导的肝切除手术对90-100%的病例达到了负面边缘；肺部转移在33%的研究中被发现。在耳鼻喉恶性肿瘤中，有25%的病例报告显示有无荧光信号的阳性边缘。总的来说，ICG在淋巴结采样和保留肾单位手术中显示了有效且安全的作用。尽管FGS的结果令人鼓舞，但ICG的使用在国际儿科肿瘤外科学界存在较大差异。不完全报道手术中的成像结果以及儿童实体肿瘤的多样性和罕见性限制了ICG在儿科肿瘤外科学中的科学证据。需要进一步的国际合作研究ICG在儿科肿瘤外科学中的应用和局限性。© 2023年。外科肿瘤学会。

Fluorescence-guided surgery (FGS) with indocyanine green (ICG) is increasingly applied in pediatric surgical oncology. However, FGS has been mostly reported in case studies of liver or renal tumors. Applying novel technologies in pediatric surgical oncology is more challenging than in adult surgical oncology due to differences in tumor histology, biology, and fewer cases. No consensus exists on ICG-guided FGS for surgically managing pediatric solid tumors. Therefore, we reviewed the literature and discuss the limitations and prospects of FGS.Using PRISMA guidelines, we analyzed articles on ICG-guided FGS for childhood solid tumors. Case reports, opinion articles, and narrative reviews were excluded.Of the 108 articles analyzed, 17 (14 retrospective and 3 prospective) met the inclusion criteria. Most (70.6%) studies used ICG to identify liver tumors, but the timing and dose of ICG administered varied. Intraoperative outcomes, sensitivity and specificity, were reported in 23.5% of studies. Fluorescence-guided liver resections resulted in negative margins in 90-100% of cases; lung metastasis was detected in 33% of the studies. In otolaryngologic malignancies, positive margins without fluorescence signal were reported in 25% of cases. Overall, ICG appeared effective and safe for lymph node sampling and nephron-sparing procedures.Despite promising results from FGS, ICG use varies across the international pediatric surgical oncology community. Underreported intraoperative imaging outcomes and the diversity and rarity of childhood solid tumors hinder conclusive scientific evidence supporting adoption of ICG in pediatric surgical oncology. Further international collaborations are needed to study the applications and limitations of ICG in pediatric surgical oncology.© 2023. Society of Surgical Oncology.