Background: We aimed to analyze the influence of near-infrared fluorescence (NIRF) using indocyanine green (ICG) with standard robot-assisted partial nephrectomy (RAPN) in patients with a kidney tumor (KT). Methods: We performed a literature search on 12 September 2023 through PubMed, EMBASE, and Scopus. The analysis included observational studies that examined the perioperative and long-term outcomes of patients with a KT who underwent RAPN with NIRF. Results: Overall, eight prospective studies, involving 535 patients, were eligible for this meta-analysis, with 212 participants in the ICG group and 323 in the No ICG group. For warm ischemia time, the ICG group showed a lower duration (weighted Mean difference (WMD) = −2.05, 95% confidence interval (CI) = −3.30–−0.80,p= 0.011). The postoperative eGFR also favored the ICG group (WMD = 7.67, 95% CI = 2.88–12.46,p= 0.002). No difference emerged for the other perioperative outcomes between the two groups. In terms of oncological radicality, the positive surgical margins and tumor recurrence rates were similar among the two groups. Conclusions: Our meta-analysis showed that NIRF with ICG during RAPN yields a favorable impact on functional outcomes, whereas it exerts no such influence on oncological aspects. Therefore, NIRF should be adopted when preserving nephron function is a paramount concern.
背景：本研究旨在分析近红外荧光（NIRF）联合吲哚菁绿（ICG）在肾肿瘤（KT）患者标准机器人辅助肾部分切除术（RAPN）中的应用效果。方法：我们于2023年9月12日通过PubMed、EMBASE和Scopus数据库进行文献检索。分析纳入观察性研究，这些研究探讨了接受NIRF辅助RAPN的肾肿瘤患者的围手术期及长期预后。结果：共纳入8项前瞻性研究，涉及535例患者，其中ICG组212例，非ICG组323例。在热缺血时间方面，ICG组持续时间更短（加权均数差（WMD）=−2.05，95%置信区间（CI）=−3.30至−0.80，p=0.011）。术后估算肾小球滤过率（eGFR）也显示ICG组更优（WMD=7.67，95% CI=2.88–12.46，p=0.002）。两组在其他围手术期结局方面无显著差异。在肿瘤根治性方面，两组的手术切缘阳性率及肿瘤复发率相似。结论：本荟萃分析表明，RAPN术中应用ICG联合NIRF技术对肾功能预后具有积极影响，但对肿瘤学结局无显著改善。因此，在肾单位功能保护至关重要时，应考虑采用NIRF技术。
肿瘤(癌症)患者之家