Evidence map›Paper›PMID 34905086›Full record

Trial reportSurgical endoscopy2022

Near infra-red fluorescence identification of the thoracic duct to prevent chyle leaks during oesophagectomy.

Thomas G Barnes, Thomas MacGregor, Bruno Sgromo, Nicholas D Maynard, Richard S Gillies

Registry-linked trialOpen access · hybridAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03292757 (FLuOrescence to Identify the Thoracic Duct During Oesophageal Resections), which is not on this map. Cited by 21 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 4 pooled it
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03292757 phase1 / phase2completednot on this map

FLuOrescence to Identify the Thoracic Duct During Oesophageal Resections

TypeinterventionalSponsorOxford University Hospitals NHS TrustRan2017 to 2018Enrolled21ConditionsChylothorax, Esophageal Cancer, Thoracic Duct Intra-Operative InjuryArmsIndocyanine Green
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 4 syntheses or guidelines pooled it, 25 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Thomas G BarnesNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK. tom.barnes@doctors.org.uk.ORCID http://orcid.org/0000-0001-7328-5797
Thomas MacGregorDepartment of Oesophagogastric Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Bruno SgromoDepartment of Oesophagogastric Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Nicholas D MaynardDepartment of Oesophagogastric Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Richard S GilliesDepartment of Oesophagogastric Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Oxford University Hospitals NHS Trust · GBNuffield Orthopaedic Centre · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChyle leaks following oesophagectomy are a frustrating complication of surgery with considerable morbidity. The use of near infra-red (NIR) fluorescence in surgery is an emerging technology and the use of fluorescence to identify the thoracic duct has been demonstrated in animal work and early human case reports. This study evaluated the use mesenteric and enteral administration of indocyanine green (ICG) in humans to identify the thoracic duct during oesophagectomy.

methodsPatients undergoing oesophagectomy were recruited to the study. Administration of ICG via an enteral route or mesenteric injection was evaluated. Fluorescence was assessed using a NIR fluorescence enabled laparoscope system with a visual scoring system and signal to background ratios. Visualisation of the thoracic duct under white light and NIR fluorescence was compared as well as any identification of active chyle leak. Patients were followed up post-operatively for adverse events and chyle leak.

results20 patients received ICG and were included in the study. The enteral route failed to fluoresce the thoracic duct. Mesenteric injection (17 patients) identified the thoracic duct under fluorescence prior to white light in 70% of patients with a mean signal to background ratio of 5.35. In 6 participants, a possible active chyle leak was identified under fluorescence with 4 showing active chyle leak from what was identified as the thoracic duct.

conclusionThis study demonstrates that ICG administration via mesenteric injection can highlight the thoracic duct during oesophagectomy and may be a potential technology to reduce chyle leak following surgery. CLINICAL

trial registrationClinical trials.gov (NCT03292757).

Indexed as

ChyleThoracic DuctEsophagectomyFluorescenceHumansIndocyanine GreenIndocyanine GreenFluorescenceIndocyanine greenMinimally invasive surgeryOesophagectomyThoracic duct leaks

Identifiers

PMID34905086
PMCPMC9160097
OpenAlexW4200518122

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.