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Clinical Consensus Statement on the Use of Indocyanine Green Fluorescence-guided Surgery in Pediatric Patients
Philipp O Szavay1, Alex Bondoc2, Ciro Esposito3
1Department of Pediatric Surgery, Lucerne Children's Hospital, Lucerne, Switzerland.
Insights
Indocyanine Green Fluorescence (ICG-F) guided surgery is a valuable tool in pediatric care. This consensus statement provides guidance on ICG-F use, safety, and indications for pediatric surgeons.
Area of Science:
- Pediatric Surgery
- Surgical Technology
- Medical Imaging
Background:
- Indocyanine Green Fluorescence (ICG-F) guided surgery is increasingly utilized in pediatric surgical settings.
- The current evidence base, safety profiles, and optimal application strategies require comprehensive evaluation.
Purpose of the Study:
- To establish an international consensus on the utility of ICG-F in pediatric surgery.
- To investigate evidence, safety, indications, and dosing strategies for ICG-F.
Main Methods:
- An international panel of 15 pediatric surgeons from 9 countries was convened.
- A structured process involving a scoping review, stakeholder discussions, and iterative voting was employed.
- Consensus statements were developed based on summarized evidence from 100 articles.
Main Results:
- Key areas of agreement included the quality of evidence, safety of Indocyanine Green (ICG), pediatric surgical indications, specialty utilization, and dosing.
- Consensus statements were generated through three rounds of anonymous voting.
Conclusions:
- This consensus provides guidance for healthcare professionals on ICG-F use in pediatric surgery.
- Highlights the need for higher-quality evidence, prospective trials, and further safety studies.
- Offers a framework for effective ICG-F utilization by pediatric surgeons.
Background And Aims:
Indocyanine Green Fluorescence (ICG-F)- guided surgery is becoming an increasingly helpful tool in pediatric surgical care. This consensus statement investigates the utility of ICG-F in various pediatric surgical applications, primarily focusing on its evidence base, safety, indications, use across different surgical specialties and dosing strategies. The aim is to establish an international consensus for ICG-F use in pediatric surgery.
Methods:
An international panel of 15 pediatric surgeons from 9 countries was assembled. The structured process consisted of a rapid scoping review, iterative discussion sessions, mixed-methods studies with key stakeholders, and voting rounds on individual statements to create draft consensus statements.
Results:
100 articles were identified during the review and summarized by application. Based on this condensed evidence, consensus statements were generated after 3 iterative rounds of anonymous voting. Key areas of agreement were quality of evidence, the safety of ICG, pediatric surgical indications, utilization per surgical specialty, and dosing of ICG.
Conclusion:
This consensus statement aims to guide healthcare professionals in managing ICG-F use in pediatric surgical cases based on the best available evidence, key stakeholder consultation, and expert opinions. Despite ICG-F's promising potential, the need for higher-quality evidence, prospective trials, and safety studies is underscored. The consensus also provides a framework for pediatric surgeons to utilize ICG-F effectively.
Level Of Evidence:
III.
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