Fluorescence and tracers in surgery: the coming future.

The revolution that we are seeing in the world of surgery will determine the way we understand surgical approaches in coming years. Since the implementation of minimally invasive surgery, innovations have constantly been developed to allow the laparoscopic approach to go further and be applied to more and more procedures. In recent years, we have been in the middle of another revolutionary era, with robotic surgery, the application of artificial intelligence and image-guided surgery. The latter includes 3D reconstructions for surgical planning, virtual reality, holograms or tracer-guided surgery, where ICG-guided fluorescence has provided a different perspective on surgery. ICG has been used to identify anatomical structures, assess tissue perfusion, and identify tumors or tumor lymphatic drainage. But the most important thing is that this technology has come hand in hand with the potential to develop other types of tracers that will facilitate the identification of tumor cells and ureters, as well as different light beams to identify anatomical structures. These will lead to other types of systems to assess tissue perfusion without the use of tracers, such as hyperspectral imaging. Combined with the upcoming introduction of ICG quantification, these developments represent a real revolution in the surgical world. With the imminent implementation of these technological advances, a review of their clinical application in general surgery is timely, and this review serves that aim.

Hallazgos oftalmológicos en pacientes con leucemia en una población colombiana / Ophthalmological findings in patients with leukaemia in a Colombian population

Objetivo Publicar las manifestaciones oculares en paciente con leucemia. Métodos Estudio observacional analítico de corte transversal, en pacientes con manifestaciones oculares por leucemia. Resultados Se evaluaron 14 ojos de 8 pacientes (5 mujeres y 3 varones) con leucemia. La edad promedio al diagnóstico de leucemia fue de 43 años (31-76 años). Seis ojos correspondían a pacientes con leucemia mieloide aguda (LMA), 4 ojos a pacientes con leucemia linfoide aguda (LLA), 2 ojos a pacientes con leucemia mieloide crónica (LMC) y 2 ojos a pacientes con leucemia de células peludas (LCP). Los hallazgos oculares primarios fueron: invasión coroidea en 12 ojos (85,7%), infiltración retiniana en 4 ojos (28,6%) y desórdenes neuroftalmológicos en 4 ojos (28,6%). La agudeza visual promedio mejoró de 0,689 a 0,449 logMAR (p 0,012) luego del tratamiento con quimioterapia sistémica e intratecal. De los 8 pacientes, 4 murieron debido a complicaciones de su enfermedad. Conclusiones Este es el primer artículo de múltiples manifestaciones oculares secundaria a leucemia en una población colombiana. Es importante tener en cuenta que este tipo de manifestaciones hacen parte de los síndromes de enmascaramiento por lo tanto es primordial hacer un diagnóstico y manejo precoz ya que en ocasiones está en riesgo la vida del paciente (AU)

Objective To report the ocular manifestations in patients with leukaemia. Methods This is a retrospective, descriptive and observational study in patients with ocular manifestations of leukaemia. Results A total of 14 eyes were evaluated corresponding to 8 patients (5 women and 3 men) with ocular manifestations of leukaemia. The mean age at diagnosis was 43 years (31-76 years). Six eyes corresponded to patients with acute myeloid leukaemia (AML), four eyes to acute lymphoid leukaemia (ALL), two eyes to chronic myeloid leukaemia (CML), and the remaining two belonged to patients with hairy cell leukaemia (HCL). The primary ocular findings were choroidal invasion in 12 eyes (85.7%), retinal infiltration in 4 eyes (28.6%), and neuro-ophthalmic disorders in 4 eyes (28.6%). The mean visual acuity improved from 0.689 to 0.449 (logMAR) (P=.012) after the systemic and intrathecal chemotherapy. Of the eight patients, four died from systemic complications of the underlying disease. Conclusions This is the first report of multiple ocular manifestations secondary to leukaemia in a Colombian population. It is important to keep in mind that this disease is included within the masquerade syndromes and that the ophthalmological findings that, while subtle, can also be devastating and be signs of a life-threatening disease (AU)

Ophthalmological findings in patients with leukaemia in a Colombian population. / Hallazgos oftalmológicos en pacientes con leucemia en una población colombiana.

OBJECTIVE: To report the ocular manifestations in patients with leukaemia. METHODS: This is a retrospective, descriptive and observational study in patients with ocular manifestations of leukaemia. RESULTS: A total of 14 eyes were evaluated corresponding to 8 patients (5 women and 3 men) with ocular manifestations of leukaemia. The mean age at diagnosis was 43 years (31-76 years). Six eyes corresponded to patients with acute myeloid leukaemia (AML), four eyes to acute lymphoid leukaemia (ALL), two eyes to chronic myeloid leukaemia (CML), and the remaining two belonged to patients with hairy cell leukaemia (HCL). The primary ocular findings were choroidal invasion in 12 eyes (85.7%), retinal infiltration in 4 eyes (28.6%), and neuro-ophthalmic disorders in 4 eyes (28.6%). The mean visual acuity improved from 0.689 to 0.449 (logMAR) (P=.012) after the systemic and intrathecal chemotherapy. Of the eight patients, four died from systemic complications of the underlying disease. CONCLUSIONS: This is the first report of multiple ocular manifestations secondary to leukaemia in a Colombian population. It is important to keep in mind that this disease is included within the masquerade syndromes and that the ophthalmological findings that, while subtle, can also be devastating and be signs of a life-threatening disease.