2023 Fiscal Year Final Research Report
Investigation of the usefulness of testicular blood flow assessment using indocyanine green in children with testicular torsion.
| Project/Area Number |
21K18101
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 90140:Medical technology assessment-related
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| Research Institution | Juntendo University |
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Principal Investigator |
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| Project Period (FY) |
2021-04-01 – 2024-03-31
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| Keywords | 急性陰嚢 / 精巣捻転 / インドシアニングリーン / ICG |
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| Outline of Final Research Achievements |
A prospective study using indocyanine green was conducted to evaluate testicular blood flow during emergency surgery for acute scrotal disease when the diagnosis of testicular torsion was confirmed intraoperatively. 7 cases were experienced. Based on a comprehensive assessment of the gross findings and medical history after the release of testicular torsion, it was decided in all cases to fix the testis in the scrotum without castration. In two cases, testicular atrophy was observed postoperatively, even though the testes were partially stained with indocyanine green after de-torsion. Those with good staining did not show a postoperative atrophic tendency and had a good prognosis in terms of echocardiography.
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| Free Research Field |
小児外科
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| Academic Significance and Societal Importance of the Research Achievements |
精巣捻転に対する緊急手術時に除睾するかどうかの判断は、発症からの経過時間や術前のエコー像、肉眼的所見などを総合的に判断して行っているが、インドシアニングリーンによる染色も補助診断として有用である可能性が考えられた。主観的な判断に補助的な診断の役割を加味する今回の研究としては、精巣に対してもインドシアニングリーンによる血流評価が有用であり、より客観的な評価である定量化への移行が期待できることが示唆された。今後も継続して症例数を蓄積し、評価法を確立しつつ機器を見直すことで、術後壊死精巣の感染や精巣捻転後の待機的除睾の機会、つまり再手術を減らすことができる可能性が考えられた。
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