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Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) ›› 2023, Vol. 17 ›› Issue (03): 323-327. doi: 10.3877/cma.j.issn.1674-3946.2023.03.023

• Original Article • Previous Articles     Next Articles

Feasibility study of indocyanine green lactigraphy for the location of nipple discharge duct and the marking of diseased glands during nipple discharge surgery

Zhao Zhang1, Chengyu Luo1,(), Ping He1, Shuqi Zhang1   

  1. 1. Department of General Surgery,Beijing Anzhen Hospital,Capital Medicine University,Beijing 100020,China
  • Received:2022-07-13 Online:2023-06-26 Published:2023-06-02
  • Contact: Chengyu Luo
  • Supported by:
    2018(the fourth batch)“Green Seedling” Project(QML20180602)

Abstract:

Objective

To investigate the feasibility and clinical value of indocyanine green emulsion duct fluoresceography in nipple discharge surgery to locate the nipple discharge duct and mark the diseased glands.

Methods

Retrospective analysis was performed on the clinical data of 178 patients with pathological nipple discharge who underwent surgical treatment from May 2018 to May 2021. Molybdenum target lactography and indocyanine green lactography were performed intraoperatively. SPSS 25.0 software was used to analyze the data. The measurement data were expressed by(

xˉ
±s),and independent sample t test was performed. The count data were represented by[n(%)]and χ2 or Fisher test was used. P<0.05 was considered statistically significant.

Results

There were 193 overflowing milk ducts in 178 patients,including 133 benign lesions(68.9%),40 malignant lesions(20.7%),and 20 borderline lesions(10.4%). Unilateral and single-hole overflow is more common,with yellow serous overflow. Mammography showed that 84(43.5%)of the milk ducts with discharge showed “trunk sign” and 109(56.5%)showed “tree sign”. The most common types of glands were inhomogeneous and dense,and mostly located in the inner and lower quadrant. Indocyanine green lactigraphy showed that 132(68.4%)of the discharge lactis were fluorescined directly through the skin,55(28.5%)were not fluorescined through the skin,and 6(3.1%)of the subcutaneous lymphatic lactis were fluorescined. There were significant differences in the development of indocyanine green in different age,pathological quadrants and molybdenum target imaging signs of discharge milk duct(P<0.05). There was no statistically significant difference in the diameter of overflow milk duct in different fluorescein imaging(P>0.05),but there was statistically significant difference in the distance between overflow milk duct and skin(P<0.05).

Conclusion

The results of indocyanine green emulsion duct fluoroscopy were related to the age of the patient,the quadrant location of the discharge duct,molybdenum target imaging signs and the distance from the discharge duct to the skin. Indocyanine green lactigraphy can accurately locate the diseased lactis,reasonably design surgical incisions,and completely remove the diseased glandular system during nipple discharge surgery,which has clinical application value.

Key words: Nipple Discharge, Surgical Procedures, Operation, Indocyanine Green, Galactography, Fluorescence Enhancement

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