1.Dual-Center Clinical Study on Detection of Intraoperative Air Leak During Pulmonary Resection Using Nebulized Indocyanine Green
Zhenfan WANG ; Songjing ZHAO ; Ruiheng JIANG ; Zhuoer CUI ; Yingtai CHEN ; Jian ZHOU ; Kezhong CHEN ; Yun LI
Medical Journal of Peking Union Medical College Hospital 2026;17(3):646-651
To evaluate the clinical value of nebulized indocyanine green(ICG) combined with near-infrared fluorescence imaging for intraoperative detection of air leaks during pulmonary resection. This was a two-center randomized controlled trial enrolling patients undergoing thoracoscopic pulmonary resection. After enrollment, patients were randomly divided into an experimental group and a control group. The experimental group received nebulized ICG and fluorescence imaging in addition to the conventional water immersion test, while the control group underwent the water immersion test alone. Intraoperative air leak detection and postoperative air leak incidence were compared between the two groups. Multivariable logistic regression analysis was performed to assess the association between ICG nebulization intervention and postoperative air leaks after adjusting for confounding factors including age, sex, smoking history, history of respiratory disease, surgical procedure, and study center. A total of 181 patients were enrolled(90 in the experimental group, 91 in the control group). The experimental group showed significantly higher intraoperative air leak detection rate(37.8% Nebulized ICG combined with near-infrared fluorescence imaging significantly improves intraoperative detection of air leaks, reduces the incidence of postoperative air leaks, and shortens chest tube duration. This technique is convenient, safe, and holds important clinical value for application.
2.Best evidence summary of perioperative fluid management in hepatectomy patients with liver cancer under the enhanced recovery after surgery concept
Xinlei ZHANG ; Liping YANG ; Jinfang YU ; Zilan QIN ; Wufeng YAO ; Zhenfan ZHOU ; Qi LI
Chinese Journal of Modern Nursing 2025;31(18):2480-2487
Objective:To comprehensively retrieve and evaluate the best available evidence on perioperative fluid management in patients undergoing hepatectomy for liver cancer, and to provide references for clinical practice.Methods:A systematic search was conducted across multiple platforms, including UpToDate, BMJ Best Practice, Guidelines International Network, National Institute for Health and Care Excellence, PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang Data, for clinical decisions, guidelines, expert consensus, systematic reviews, evidence summaries, and randomized controlled trials related to perioperative fluid management in patients undergoing hepatectomy for liver cancer. The search period was from database inception to March 13, 2024. The 2014 version of the Joanna Briggs Institute evidence pre-grading and recommendation grading system was used to classify the evidence.Results:A total of 14 articles were included: 3 clinical decision articles, 3 guidelines, 1 evidence summary, 5 expert consensuses, 1 systematic review, and 1 randomized controlled trial. A total of 27 best evidence items were extracted, covering seven aspects: principles of fluid therapy, preoperative fluid management, intraoperative fluid management, postoperative fluid management, fluid type selection, assessment and monitoring, and training and education.Conclusions:This study summarizes the best evidence on perioperative fluid management for hepatectomy in liver cancer patients and provides an evidence-based reference for clinical nursing practice. Healthcare professionals should apply the evidence in a personalized manner based on the actual clinical context to promote scientific fluid management in the perioperative period.
3.Best evidence summary of perioperative fluid management in hepatectomy patients with liver cancer under the enhanced recovery after surgery concept
Xinlei ZHANG ; Liping YANG ; Jinfang YU ; Zilan QIN ; Wufeng YAO ; Zhenfan ZHOU ; Qi LI
Chinese Journal of Modern Nursing 2025;31(18):2480-2487
Objective:To comprehensively retrieve and evaluate the best available evidence on perioperative fluid management in patients undergoing hepatectomy for liver cancer, and to provide references for clinical practice.Methods:A systematic search was conducted across multiple platforms, including UpToDate, BMJ Best Practice, Guidelines International Network, National Institute for Health and Care Excellence, PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang Data, for clinical decisions, guidelines, expert consensus, systematic reviews, evidence summaries, and randomized controlled trials related to perioperative fluid management in patients undergoing hepatectomy for liver cancer. The search period was from database inception to March 13, 2024. The 2014 version of the Joanna Briggs Institute evidence pre-grading and recommendation grading system was used to classify the evidence.Results:A total of 14 articles were included: 3 clinical decision articles, 3 guidelines, 1 evidence summary, 5 expert consensuses, 1 systematic review, and 1 randomized controlled trial. A total of 27 best evidence items were extracted, covering seven aspects: principles of fluid therapy, preoperative fluid management, intraoperative fluid management, postoperative fluid management, fluid type selection, assessment and monitoring, and training and education.Conclusions:This study summarizes the best evidence on perioperative fluid management for hepatectomy in liver cancer patients and provides an evidence-based reference for clinical nursing practice. Healthcare professionals should apply the evidence in a personalized manner based on the actual clinical context to promote scientific fluid management in the perioperative period.

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